Term
| pt is allergic to pen and has nephropathy so he was unable to tollerate aminoglycoside. what is the drug that could tx his pseudonomas lung infection. |
|
Definition
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|
Term
| what drug would add to piperacillin to inc the spectrum of coverage against G- and S. aureus. |
|
Definition
| Tazobactam as piperacillin tx mostly G- rods |
|
|
Term
| what is a major side effect of imipenem |
|
Definition
| Seizures at high serum levels, especially in renal insufficient pt. |
|
|
Term
| imipenem is deactivated in kidney by an enzyme. to deactivate this enzyme and inc half life of imipenem a drug is given. please kindly give the name of the drug... |
|
Definition
| Cilastatin - by itself no bac activity |
|
|
Term
| which cephalosporins generation is not effective against B-lactamases |
|
Definition
|
|
Term
| two main drugs could cause disulfiram like rxn |
|
Definition
| cephalosporins and metronidazole |
|
|
Term
| list all aminooglycosides |
|
Definition
| Gentamicin, streptomycin, tobramycin, amikacin, neomycin |
|
|
Term
| two main side effects of aminoglycosides |
|
Definition
|
|
Term
| drug of choice for endocarditis acute and subacute |
|
Definition
Acute Bacterial Endocarditis Staph Aureus Vancomycin + gentamicin
Subacute Bacterial Endocarditis Viridans strep, Enterococci Penicillin + Gentamicin |
|
|
Term
| pseudomembrane colitis is casued by what drug |
|
Definition
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|
Term
| drug that is given as prophylaxis for GI surgery |
|
Definition
|
|
Term
| what is a good group of antibiotics for atypical pneumonia? |
|
Definition
| macrolides --specially erythromycin |
|
|
Term
| which class of drug will increase the amount of warfarin, cyclosporine, and theophylline in the serum? |
|
Definition
| erythromycin, fluconazole, ketoconazole and Nevirapine becz it inhibits cytochrome P450 enzyme |
|
|
Term
Lyme disease --what is the tx.
what could tx diphteria? |
|
Definition
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|
Term
|
Definition
|
|
Term
| what causes fanconi syndrome? |
|
Definition
|
|
Term
| renally insufficent pt has rocky mountain spotted fever --what is the tx |
|
Definition
| doxycycline can be used in renally insufficient pt since it is fecally eliminated. |
|
|
Term
| you should not eat two kind of food becz it inhibits tetracycline absorption |
|
Definition
|
|
Term
| name of the drug that is used in tx for SIADH |
|
Definition
| Demeclocycline (tetracycline)ADH receptor antagonist |
|
|
Term
this drug could cause steven johnson
(2 drugs) + hemolytic anemia. |
|
Definition
Septra DS
Nevirapine-cause only steven johnson |
|
|
Term
| SE for this drugs are Kernicterus in newborn |
|
Definition
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|
Term
| first line for Morozella catarralis and P. Carinni |
|
Definition
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|
Term
42. The elimination half-life of which of the following tetracyclines remains
unchanged when the drug is administered to an anuric patient?
a. Methacycline
b. Oxytetracycline
c. Doxycycline
d. Tetracycline
e. None of the above |
|
Definition
Doxy: This is of clinical importance in patients with impaired renal
function. With the exception of doxycycline, tetracyclines should not be
used in patients that are anuric. Doxycycline is excreted by the GI tract
under these conditions, and it will not accumulate in the serum of patients
with renal insufficiency. |
|
|
Term
what drug causes psuedomembraneous colitis?
and what drug would tx it? |
|
Definition
SE of Clindamycin.
tx with Vancomycin |
|
|
Term
| this antibiotic inhibits P-450 which then ends up inc warfarin, cyclosporine, and theophylline. and this drug induces P450 and eleminates this drugs from the body. |
|
Definition
erythromycin - inhibits P450
Rifampin and Nevirapine- induces P450 |
|
|
Term
| phenytoin and phenobarbital dec level of this drug and cimetidine inc the level..name the drug |
|
Definition
|
|
Term
| this drug creats harmless orange color urine. |
|
Definition
| Rifampin. SE: sweat, thrombocytopenia, nephritis, hepatitis |
|
|
Term
| peripheral neuropathy and drug induced lupus....damn why should i take this drug again? |
|
Definition
| Isoniazid-pyridoxine and B6 is given to prevent peripheral neuropahty in pt taking isoniazid |
|
|
Term
| what enzyme in liver metabolize isoniazid |
|
Definition
| N-acetyltransferase. serum level should be checked becz some people might secret faster than others |
|
|
Term
| this 3 drugs cause hemolytic anemia in G6PD pt. |
|
Definition
| DAP(dapsone), isoniazide, nitrofurantoin |
|
|
Term
| Tx for chronic hepatitis B |
|
Definition
| Lamivudine and Adefovir and Entecavir |
|
|
Term
| which drug is shown to reduce vertical transmission of HIV. |
|
Definition
|
|
Term
| 3 big groups of drugs that are used in tx HIV |
|
Definition
NNRTI
NRTI
protease inhibitors |
|
|
Term
| acyclovir is active against 4 viruses what are they? |
|
Definition
|
|
Term
| CMV infeciton (mainly in eye) is tx with what? what is 2nd line tx? |
|
Definition
|
|
Term
pancytopenia SE-what drug
neurotoxicity what viral drug? |
|
Definition
Ganciclovir
Acyclovir-neurotoxic |
|
|
Term
this drugs enters CNS and stimulate dopamine release in sub.nigra. but the main purpose is different. SE are Ataxia, slurred speech, dizziness. GI upset
name the drug and purpose |
|
Definition
|
|
Term
| this drug is used mainly in pediatric hospital and preg Resp therapist wont be allowed to use it on pt while they are in the room. what is this drug that also cant be used in renal insufficiency? |
|
Definition
|
|
Term
| Ribavirin is used for which viruses? |
|
Definition
|
|
Term
| this drug is given in intrathecally as it doesn cross BBB but it is important to tx fungal meningitis. |
|
Definition
|
|
Term
| Nystatin --is it stronger than ampho B or weaker? main purpose of use and route |
|
Definition
| tx oral and cutaneous candidiasis. not given systemically as it is stronger and more toxic than ampho B |
|
|
Term
In patients with hepatic coma, decreases in the production and absorption
of ammonia from the gastrointestinal (GI) tract will be beneficial. The
antibiotic of choice in this situation would be
a. Neomycin
b. Tetracycline
c. Penicillin G
d. Chloramphenicol
e. Cephalothin |
|
Definition
|
|
Term
41. A 19-year-old woman is diagnosed with tuberculosis (TB). Before prescribing
a drug regimen, you take a careful medication history because one
of the drugs commonly used to treat TB induces microsomal cytochrome
P450 enzymes in the liver. Which drug is this?
a. Isoniazid
b. Rifampin
c. Pyrazinamide
d. Ethambutol
e. Vitamin B6 |
|
Definition
|
|
Term
In the treatment of bacterial meningitis in children, the drug of choice is
a. Penicillin G
b. Penicillin V
c. Erythromycin
d. Procaine penicillin
e. Ceftriaxone |
|
Definition
Ceftriaxone
43. The answer is e. (Hardman, pp 1094–1095.) Penicillins were used in
the treatment of meningitis because of their ability to pass across an
inflamed blood-brain barrier. The third-generation cephalosporin, ceftriaxone,
is preferred because it is effective against β-lactamase producing
strains of H. influenzae that may cause meningitis in children. |
|
|
Term
47. In the treatment of infections caused by P. aeruginosa, the antimicrobial
agent that has proved to be effective is
a. Penicillin G
b. Piperacillin
c. Nafcillin
d. Erythromycin
e. Tetracycline |
|
Definition
piperacillin
The answer is b. (Hardman, pp 1077–1086.) Piperacillin is a broadspectrum,
semisynthetic penicillin for parenteral use. Its spectrum of activity
includes various Gram-positive and Gram-negative organisms including
Pseudomonas. The indications for piperacillin are similar to those for carbenicillin,
ticarcillin, and mezlocillin, with the primary use being suspected or proven infections caused by P. aeruginosa. Penicillin G, nafcillin,
erythromycin, and tetracycline are ineffective against Pseudomonas. |
|
|
Term
| SE: red and green color blindness |
|
Definition
|
|
Term
The most active aminoglycoside against Mycobacterium tuberculosis is
a. Streptomycin
b. Amikacin
c. Neomycin
d. Tobramycin |
|
Definition
49. The answer is a. (Hardman, pp 1105–1108.) The activity of streptomycin
is bactericidal for the tubercle bacillus organism. Other aminoglycosides
(e.g., gentamicin, tobramycin, neomycin, amikacin, and kanamycin)
have activity against this organism but are seldom used clinically because of
toxicity or development of resistance. |
|
|
Term
The drug used in all types of TB is
a. Ethambutol
b. Cycloserine
c. Streptomycin
d. INH
e. PAS |
|
Definition
|
|
Term
Chronic candidiasis infections of the GI tract and oral cavity are treated
with which agent in pill form
a. Amphotericin B
b. Nystatin
c. Miconazole
d. Fluconazole
e. Clotrimazole |
|
Definition
The answer is d. (Hardman, pp 1183–1184.) Mucocutaneous infections,
most commonly Candida albicans, involve the moist skin and mucous
membranes. Agents used topically include amphotericin B, nystatin, miconazole,
and clotrimazole. Ketoconazole and fluconazole are administered orally
in pill form for treatment of chronic infections. |
|
|
Term
For the treatment of a patient with Legionella pneumophila, the drug of
choice would be
a. Penicillin G
b. Chloramphenicol
c. Erythromycin
d. Streptomycin
e. Lincomycin |
|
Definition
c. (Hardman, pp 1135–1141.) Erythromycin, a macrolide
antibiotic, was initially designed to be used in penicillin-sensitive patients with streptococcal or pneumococcal infections. Erythromycin has
become the drug of choice for the treatment of pneumonia caused by
Mycoplasma and Legionella. |
|
|
Term
54. The most effective agent in the treatment of Rickettsia, Mycoplasma,
and Chlamydia infections is
a. Penicillin G
b. Tetracycline
c. Vancomycin
d. Gentamicin
e. Bacitracin |
|
Definition
The answer is b. (Hardman, p 1128.) Tetracycline is one of the drugs
of choice in the treatment of Rickettsia, Mycoplasma, and Chlamydia infections.
The antibiotics that act by inhibiting cell-wall synthesis have no
effect on Mycoplasma because the organism does not possess a cell wall;
penicillin G, vancomycin, and bacitracin will be ineffective. Gentamicin
has little or no antimicrobial activity with these organisms. |
|
|
Term
56. Vertigo, inability to perceive termination of movement, and difficulty
in sitting or standing without visual clues are some of the toxic reactions
that are likely to occur in about 75% of patients treated with
a. Penicillin G
b. Doxycycline
c. Amphotericin B
d. Streptomycin
e. INH |
|
Definition
The answer is d. (Hardman, pp 1110–1113.) Streptomycin and other
aminoglycosides can elicit toxic reactions involving both the vestibular and
auditory branches of the eighth cranial nerve. Patients receiving an aminoglycoside
should be monitored frequently for any hearing impairment
owing to the irreversible deafness that may result from its prolonged use.
None of the other agents listed in the question adversely affect the function
of the eighth cranial nerve. |
|
|
Term
| tx for systemic mycotic infecitons including candidemia and aspergillosis |
|
Definition
|
|
Term
| tx for systemic mycotic infection and fungal meningitis caused by cryptococcus and candida species |
|
Definition
|
|
Term
| this drug SE is to inhibit hormone synthesis which causes dec libido and menstrual irregularities |
|
Definition
| Ketoconazole--also causes gynecomastia |
|
|
Term
| to treat topical dermatophytic infection two drugs could be used. |
|
Definition
|
|
Term
to tx drug resistance p falciparum malaria
what if the P.vivax is found in the blood smear. |
|
Definition
quinine or mefloquine
extraerythrocytic p. vivax = primaquine
intraerythrocytic - chloroquine |
|
|
Term
| does mefloquine enter CNS? |
|
Definition
| yes it causes mental status changes |
|
|
Term
| what drug is given as prophylaxis for P. Carinii pneumonia? |
|
Definition
| Pentamidine: SE: pancreatic damage, cardiac arrhythmias, nephrotoxicity |
|
|
Term
| treatment for T. brucei infeciton |
|
Definition
|
|
Term
|
Definition
|
|
Term
| tx for whipworm, hookworm, pinworm, round worm |
|
Definition
Mebendazole
Pyrantel pamoate: hookworm, round worm, and pinworm---pyramid of worm |
|
|
Term
|
Definition
| Niclosamide ------nicole got tape worm |
|
|
Term
60. A 39-year-old male with aortic insufficiency and a history of no drug
allergies is given an intravenous dose of antibiotic as a prophylaxis preceding
the insertion of a valve prosthesis. As the antibiotic is being infused, the
patient becomes flushed over most of his body. What antibiotic was given?
a. Vancomycin
b. Gentamicin
c. Erythromycin
d. Penicillin G
e. Tetracycline |
|
Definition
60. The answer is a. (Hardman, p 1146.) The “red man” syndrome is
associated with vancomycin, thought to be caused by histamine release.
Prevention consists of a slower infusion rate and pretreatment with antihistamines. |
|
|
Term
63. A 75-year-old woman is hospitalized for pneumonia and treated with
an intravenous antibiotic. On day three, she develops severe diarrhea. Stool
is positive for Clostridium difficile toxin. What is the best treatment?
a. Clindamycin
b. Cefaclor
c. Metronidazole
d. Erythromycin
e. Doxycycline |
|
Definition
The answer is c. (Hardman, pp 996–997, 1145–1146. Katzung, p 845.)
Metronidazole is often used to treat antibiotic-associated enterocolitis,
especially when caused by C. difficile. Vancomycin is no longer preferred
because it induces selection of resistant staphylococci. Clindamycin is also
associated with C. difficile colitis, but in another way: a higher percentage of
patients taking this over other antibiotics develop antibiotic-associated
enterocoliti |
|
|
Term
64. A jaundiced one-day-old premature infant with an elevated free bilirubin
is seen in the premature-baby nursery. The mother received an antibiotic
combination preparation containing sulfamethizole for a urinary tract
infection (UTI) one week before delivery. You suspect that the infant’s findings
are caused by which antibiotic intake:
a. Ofloxacin
b. vancomycin
c. Ribavirin
d. cipro
e. Sulfadoxine |
|
Definition
| sulfadoxine is sulfonamides justlike TMP-SMX |
|
|
Term
65. A 27-year-old female has just returned from a trip to Southeast Asia.
In the past 24 hours, she has developed shaking, chills, and a temperature
of 104°F. A blood smear reveals Plasmodium vivax. Which of the following
agents should be used to eradicate the extraerythrocytic phase of the
organism?
a. Primaquine
b. Pyrimethamine
c. Quinacrine
d. Chloroquine
e. Chloroguanide |
|
Definition
65. The answer is a. (Hardman, pp 977–978.) Primaquine is effective
against the extraerythrocytic forms of P. vivax and P. ovale and is thus of
value in a radical cure of malarial infection. It also attacks the sexual forms
of the parasite, rendering them incapable of maturation in the mosquito
and making it valuable in preventing the spread of malarial infection. |
|
|
Term
66. An 86-year-old male complains of cough and blood in his sputum for
the past two days. On admission, his temperature is 103°F. Physical examination
reveals rales in his right lung, and x-ray examination shows increased
density in the right middle lobe. A sputum smear shows many Gram-positive
cocci, confirmed by sputum culture as penicillinase-producing Staphylococcus
aureus. Which of the following agents should be given?
a. Ampicillin
b. Oxacillin
c. Carbenicillin
d. Ticarcillin
e. Mezlocillin |
|
Definition
66. The answer is b. (Hardman, p 1077.) Unlike the other listed drugs,
oxacillin is resistant to penicillinase. The other four agents are broadspectrum
penicillins, while oxacillin is generally specific for Gram-positive
microorganisms. Use of penicillinase-resistant penicillins should be reserved
for infections caused by penicillinase-producing staphylococci. |
|
|
Term
| AZT (zidovudine) causes this side effect that is seen in most pt |
|
Definition
|
|
Term
68. Thiabendazole, a benzimidazole derivative, is an antihelminthic drug
used primarily to treat infections caused by
a. Ascaris lumbricoides (roundworm)
b. N. americanus (hookworm)
c. Strongyloides
d. Enterobius vermicularis
e. Taenia saginata (flatworm) |
|
Definition
The answer is c. (Hardman, p 1688.) Thiabendazole has been
shown to be effective against Strongyloides, cutaneous larva migrans, and
Trichuris. Adverse effects consist of nausea, vertigo, headache, and weakness.
Treatment usually involves oral administration for several days. It
has been found to be ineffective in Ascaris, N. americanus, E. vermicularis,
and T. saginata. |
|
|
Term
70. The mechanism of action of chloroquine in Plasmodium falciparum
malaria is elimination of
a. Secondary tissue schizonts
b. Exoerythrocytic schizonts
c. Erythrocytic stage
d. Asexual forms
e. Sporozoites |
|
Definition
70. The answer is c. (Hardman, pp 970–972.) Chloroquine is a 4-
aminoquinoline derivative that selectively concentrates in parasitized red
blood cells. It is a weak base, and its alkalinizing effect on the acid vesicle
of the parasite effectively destroys the viability of the parasite |
|
|
Term
just incase he changes his mind
71. The use of chloramphenicol may result in
a. Bone marrow stimulation
b. Phototoxicity
c. Aplastic anemia
d. Staining of teeth
e. Alopecia |
|
Definition
| Aplastic anemia and gray baby syndrome |
|
|
Term
72. A drug primarily used in pneumonia caused by Pneumocystis carinii is
a. Nifurtimox
b. Penicillin G
c. Metronidazole
d. Pentamidine
e. Carbenicillin |
|
Definition
The answer is d. (Hardman, p 989.) Both trimethoprimsulfamethoxazole
and pentamidine are effective in pneumonia caused by
P. carinii. This protozoal disease usually occurs in immunodeficient
patients, such as those with AIDS. Nifurtimox is effective in trypanosomiasis
and metronidazole in amebiasis and leishmaniasis, as well as in
anaerobic bacterial infections. Penicillins are not considered drugs of
choice for this particular disease state. |
|
|
Term
76. Which of the following may cause damage to growing cartilage?
a. Fluoroquinolones
b. Sulfonamides
c. Aminoglycosides
d. Cephalosporins
e. Tetracyclines |
|
Definition
The answer is a. (Katzung, p 800.) Fluoroquinolones are not recommended
in patients less than 18 years old. They have a tendency to damage
growing cartilage and cause arthropathy. The arthropathy is generally
reversible. Tendinitis may occur, and in rare instances in adults, this finding
may lead to tendon ruptures. |
|
|
Term
A patient with AIDS is treated with a combination of agents, which
includes efavirenz. What is the mechanism of action of efavirenz?
a. Inhibition of RNA synthesis
b. Inhibition of DNA synthesis
c. Inhibition of viral particle assembly
d. Inhibition of viral proteases
e. Inhibition of nucleoside reverse transcriptase
f. Inhibition of nonnucleoside reverse transcriptase |
|
Definition
The answer is f. (Katzung, p 837.) Efavirenz is a specific inhibitor of
HIV-1 viral growth. Its mechanism of action involves inhibition of nonnucleoside
reverse transcriptase. |
|
|
Term
| which three drugs are NNRTIs..because other protease inhibitor also have vir in the name. |
|
Definition
Ne-virapine
Efa-virenz
Dela-virdine |
|
|
Term
Of the following, the most appropriate statement concerning the reactions
caused by aminoglycosides is that these agents
a. Produce ototoxicity
b. Are potent neuromuscular blockers
c. Have little or no effect on kidneys
d. Produce a high incidence of hypersensitivity reactions similar to those of penicillins
e. Produce a high incidence of exfoliative dermatitis |
|
Definition
79. The answer is a. (Hardman, pp 1110–1111.) All the aminoglycosides
are potentially toxic to both branches of the eighth cranial nerve. The evidence
indicates that the sensory receptor portions of the inner ear are affected
rather than the nerve itself. Nephrotoxicity may develop during or after the
use of an aminoglycoside. It is generally more common in the elderly when
there is preexisting renal dysfunction. In most patients, renal function gradually
improves after discontinuation of therapy. Aminoglycosides rarely
cause neuromuscular blockade that can lead to progressive flaccid paralysis
and potential fatal respiratory arrest. Hypersensitivity and dermatologic reactions
occasionally occur following use of aminoglycosides. |
|
|
Term
A 27-year-old male with a three-year history of AIDS complains of
progressive blurring of vision for two days. Eye examination reveals evidence
of retinitis consistent with cytomegalic virus inclusion disease. Intravenous
treatment is started, and within five days the patient complains of
muscular weakness and cramping. Blood chemistries show a creatinine of
5.2 mEq/L and a Ca of 6.9 mEq/L. |
|
Definition
Foscarnet...I know I know the first line is Ganciclovir but they put this as an answer because
The answer is d. (Hardman, p 1200. Katzung, p 830.) Nephrotoxicity
and symptomatic hypocalcemia are major toxicities associated with foscarnet.
Underlying renal disease, concomitant use of nephrotoxic drugs,
dehydration, and rapid infusion of high doses increase the risk. |
|
|
Term
83. The drug of choice for the treatment of T. saginata (tapeworm) is
a. Mebendazole
b. Ceftriaxone
c. Primaquine
d. Niclosamide
e. Chloroquine |
|
Definition
83. The answer is d. (Hardman, p 1019.) Niclosamide is a halogenated
salicylanilide derivative. It exerts its effect against cestodes by inhibition of
mitochondrial oxidative phosphorylation in the parasites. The mechanism
of action is also related to its inhibition of glucose and oxygen uptake in the
parasite. |
|
|
Term
84. The drug of choice for the treatment of Schistosoma haematobium is
a. Praziquantel
b. Ceftriaxone
c. Metronidazole
d. Mebendazole
e. Diethylcarbamazine |
|
Definition
The answer is a. (Hardman, pp 1020–1022.) Praziquantel is a broadspectrum
antihelminthic agent. It appears to kill the adult schistosome by increasing the permeability of the cell membranes of the parasite to Ca and
consequent influx of Ca ions. This causes increased muscle contraction followed
by paralysis. |
|
|
Term
85. Ampicillin and amoxicillin are in the same group of penicillins. Which
of the following statements best characterizes amoxicillin?
a. It has better oral absorption than does ampicillin
b. It can be used in penicillinase-producing organisms
c. It is classified as a broad-spectrum penicillin
d. It does not cause hypersensitivity reactions
e. It is effective against Pseudomonas |
|
Definition
85. The answer is a. (Hardman, pp 1084–1085.) Amoxicillin is classified
as an aminopenicillin along with ampicillin. Because it is less affected than
ampicillin by the presence of food, it has a superior absorption in the GI
tract. It is sensitive to penicillinase and has a narrow spectrum of activity
toward certain Gram-positive and Gram-negative organisms, but not
Pseudomonas. Because it is in the penicillin family, hypersensitivity reactions
are a possibility. |
|
|
Term
86. A 60-year-old male with AIDS develops a systemic fungal infection that
is treated with fluconazole. What is the mechanism of action of fluconazole?
a. It inhibits ergosterol synthesis
b. It inhibits DNA synthesis
c. It inhibits peptidoglycan synthesis
d. It inhibits protein synthesis |
|
Definition
86. The answer is a. (Hardman, p 1180. Katzung, pp 817–819.) Fluconazole
indirectly inhibits ergosterol synthesis. It inhibits cytochrome P450,
which is a key enzyme system for cytochrome P450–dependent sterol
14-α-demethylase. This leads to accumulation of 14-α-sterols, resulting in
impairment of the cytoplasmic membrane. |
|
|
Term
A 50-year-old male diabetic develops an external otitis from which
Pseudomonas organisms are cultured. Topical therapy with polymyxin is
effective. What is the mechanism of action of polymyxin?
a. Inhibition of cell-wall synthesis
b. Formation of reactive cytotoxic products that interfere with DNA synthesis
c. Disruption of membrane permeability
d. Inactivation of protein sulfhydryl groups
e. Inhibition of protein synthesis by binding to transfer RNA (tRNA) |
|
Definition
it is under vancomycin in f.cards. it is very toxic so right now it is used only topically.
The answer is c. (Hardman, pp 1143–1144.) Bacitracin, cycloserine,
cephalothin, and vancomycin inhibit cell-wall synthesis and produce bacteria
that are susceptible to environmental conditions. Polymyxins disrupt
the structural integrity of the cytoplasmic membranes by acting as cationic
detergents. On contact with the drug, the permeability of the membrane
changes. Polymyxin is often applied in a mixture with bacitracin and/or
neomycin for synergistic effects. |
|
|
Term
88. A 75-year-old male develops a cough that produces blood-tinged sputum.
He has a fever of 104°F. Gram-positive cocci in clusters are found in a
sputum smear. A chest x-ray shows increased density in the right upper
lobe. Of the following penicillins, which is most likely to be ineffective?
a. Oxacillin
b. Cloxacillin
c. Ticarcillin
d. Nafcillin
e. Dicloxacillin |
|
Definition
remember b4 reading -- pipercillin (ticarcillin and carbenicillin) all are given with Tazobactam to broaden the spectrum for B-lactamases
88. The answer is c. (Hardman, p 1086.) Ticarcillin resembles carbenicillin
and has a high degree of potency against Pseudomonas and Proteus organisms
but is broken down by penicillinase produced by various bacteria, including
most staphylococci. Oxacillin, cloxacillin, nafcillin, and dicloxacillin are all
resistant to penicillinase and are effective against staphylococci. |
|
|
Term
90. A 45-year-old female being treated for a chronic UTI develops acute
alcohol intolerance. Which of the following agents could have caused this
intolerance?
a. Cefoperazone
b. Amoxicillin
c. Sulfamethoxazole-trimethoprim
d. Norfloxacin
e. Tetracycline |
|
Definition
The answer is a. (Hardman, pp 1086–1089.) Intolerance of alcohol
(disulfiram-like reaction) has been noted only with certain cephalosporins.
Cephalosporins with the methylthiotetrazole side chain have been associated
with a disulfiram-like reaction because the methylthiotetrazole group has a
configuration similar to disulfiram, |
|
|
Term
92. A 65-year-old male with a pneumonia has a sputum culture that is
positive for a staphylococcal strain that is β-lactamase-positive. Which is
the best choice of penicillin therapy in this patient?
a. Ampicillin
b. Oxacillin
c. Ticarcillin
d. Penicillin G
e. Carbenicillin |
|
Definition
92. The answer is b. (Hardman, p 1077.) Oxacillin is classified as a
penicillinase-resistant penicillin that is relatively acid-stable and, therefore,
is useful for oral administration. Major adverse reactions include penicillin
hypersensitivity and interstitial nephritis. With the exception of methicillin,
which is 35% bound to serum proteins, all penicillinase-resistant
penicillins are highly bound to plasma proteins. Oxacillin has a very narrow
spectrum and is used primarily as an antistaphylococcal agent. |
|
|
Term
93. A 35-year-old female complains of itching in the vulval area. Hangingdrop
examination of the urine reveals trichomonads. What is the preferred
treatment for trichomoniasis?
a. Doxycycline
b. Pyrimethamine
c. Pentamidine
d. Emetine
e. Metronidazole |
|
Definition
93. The answer is e. (Hardman, pp 995–998.) Metronidazole is a lowmolecular-
weight compound that penetrates all tissues and fluids of the
body. Metronidazole’s spectrum of activity is limited largely to anaerobic
bacteria—including B. fragilis—and certain protozoa. It is considered to be
the drug of choice for trichomoniasis in females and carrier states in males,
as well as intestinal infections with Giardia lamblia. |
|
|
Term
94. A 40-year-old female with duodenal ulcers is treated with a combination
of agents that includes clarithromycin. Of the following enzymes,
which is inactivated by clarithromycin?
a. Dihydrofolate reductase
b. Glucose-6-phosphate dehydrogenase
c. Cytochrome P450
d. Na+,K+-ATPase
e. Na+,K+,Cl− co-transporter |
|
Definition
94. The answer is c. (Katzung, pp 778–780.) Clarithromycin is a
macrolide antibiotic. It can inhibit cytochrome P450. This could lead to
an increase in concentration of drugs that are metabolized by cytochrome
P450 and are given simultaneously with clarithromycin. When given with
terfenadine, an antihistaminic agent, the interaction may lead to cardiac
arrhythmias. |
|
|
Term
95. A 30-year-old type I diabetic with renal complications develops acute
pyelonephritis. P. aeruginosa is found in urine cultures and blood cultures.
Combined therapy is instituted with an aminoglycoside and which of the
following?
a. Clavulanic acid
b. Vancomycin
c. A second-generation cephalosporin
d. Azithromycin
e. Piperacillin |
|
Definition
95. The answer is e. (Katzung, p 761.) Piperacillin is effective against
P. aeruginosa. The ease with which these organisms develop resistance with
single-drug therapy has necessitated that combination with aminoglycosides
be used in pseudomonal infections. |
|
|
Term
96. A 35-year-old male is diagnosed with primary syphilis. Which of the
following agents is the best choice for treating this patient?
a. A first-generation cephalosporin
b. Oxacillin
c. Imipenen
d. Benzathine penicillin G
e. Vancomycin |
|
Definition
96. The answer is d. (Hardman, pp 1080–1082. Katzung, pp 759–760.)
Because of its long duration of action, benzathine penicillin G is given as a
single injection of 1.2 million units intramuscularly every three or four
weeks for the treatment of syphilis. This persistence of action reduces the
need for repeated injections, costs, and local trauma. Benzathine penicillin
G is also administered for group A, β-hemolytic streptococcal pharyngitis
and pyoderma. For the later stages of syphilis, up to three weekly doses of
the agent is administered. |
|
|
Term
97. A 20-year-old male has a urethral discharge. Culture of the discharge
shows Neisseria gonorrhoeae. Which of the following agents is the best choice
for treating this patient?
a. Ceftriaxone
b. Benzathine penicillin G
c. Imipenen
d. Amikacin
e. Sulfamethoxazole-trimethoprim |
|
Definition
97. The answer is a. (Hardman, p 1082. Katzung, pp 764–766.) The thirdgeneration
cephalosporin, ceftriaxone, and cefixime are considered firstline
drugs in the treatment of gonorrhea because most strains of Neisseria
gonococci are resistant to the penicillins. Amikacin and other aminoglycosides
are used in serious infections caused by E. coli, Enterobacter, Klebsiella,
and Serratia species. However, spectinomycin, which is related to the
aminoglycosides, can be used as a backup drug for gonorrhea. |
|
|
Term
| Wuchereria bancrofti (filariae) |
|
Definition
|
|
Term
|
Definition
| induction of carpopedal spasm by blood pressure cuff. |
|
|
Term
|
Definition
contraction of ipsilateral facial muscle by tapping the facial nerve.
Remember prolong QT due to hypoCa++ |
|
|
Term
| An elevated thyroid peroxidase antibody (TPO) level is diagnostic for which thyroid disorder? |
|
Definition
|
|
Term
| which thyroiditis has viral in origin |
|
Definition
|
|
Term
| what is the other name of toxic diffuse goiter |
|
Definition
|
|
Term
| What medication can be given to block enterohepatic recirculation of thyroid hormone? |
|
Definition
| Cholestyramine 4 gm oral every 6 hours. |
|
|
Term
| What is the most common extra-articular manifestation of ankylosing spondylitis? |
|
Definition
| Mc is Uveitis. but other manifestation are psorias, IBD |
|
|
Term
| Which anatomical structures are involved in the “unhappy triad” |
|
Definition
| Answer: Anterior cruciate ligament, medial meniscus and medial collateral ligaments. |
|
|
Term
| Pellagra? Pediculosis? Podagra? |
|
Definition
| Vitamin B def. lice. great toe’s metatarsophalangeal joint, which is termed podagra. |
|
|
Term
|
Definition
Question: Which type of foot anomaly is plantar fasciitis common in?
high arch is called cavus |
|
|
Term
| Lateral radiographs typically show spicules of heterotopic ossification anterior to the tibial tuberosity. |
|
Definition
| Tibial tuberosity osteochondritis is called Osgood-Schlatter disease |
|
|
Term
| gottron papules. female with this should also be checked for |
|
Definition
dermatomyositis
Ovarian cancer - as it is associated with dermatomyositis. |
|
|
Term
|
Definition
|
|
Term
| Proximal fib neck fracture - which nerve is injured |
|
Definition
|
|
Term
| for carpel tunnel syndrome which test is most sensitive |
|
Definition
| Median nerve compression testing (Durkan’s test) |
|
|
Term
| Question: What are the two most common primary sources of spinal metastatic disease? |
|
Definition
|
|
Term
| What is the most common type of bursitis? |
|
Definition
| Subacromial (subdeltoid) bursitis. |
|
|
Term
| This finding is called “rat bite necrosis” and is characteristic of _________ |
|
Definition
| scleroderma. Pt has finger tip ulceration |
|
|
Term
| Heberden nodes refer to what physical examination finding? |
|
Definition
|
|
Term
| how many + trigger points for fibro dx |
|
Definition
| At least eleven of eighteen symmetrical trigger points. |
|
|
Term
| Which of the following tuberculosis medications is commonly associated with lupus-like syndrome? |
|
Definition
| Isoniazid is one of a number of drugs that is associated with the development of a lupus-like syndrome. Drug-induced lupus is SLE-like but self-resolving. The illness is characterized by arthralgias, rash, serositis and myalgias. |
|
|
Term
| Ganglion cysts Which of the following is the most appropriate first step in management? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| one of the most common DMARD adverse affect on body. that should be checked by testing this every 3 months. |
|
Definition
| one of the most common DMARD adverse events is bone marrow suppression, |
|
|
Term
| in ankylosing spondylitis most common extra-articular manifestation |
|
Definition
|
|
Term
| Question: Which of the hepatitis viruses is the only one which is a DNA virus |
|
Definition
|
|
Term
| Which of the following is the most common infectious etiology of diarrhea in patients with AIDS? |
|
Definition
| In patients with AIDS, cryptosporidium is a common cause of diarrhea when the CD4 count falls below 100 cells/mm3. |
|
|
Term
|
Definition
| ndinavir (B) is a protease inhibitor used in the treatment of HIV. Nephrolithiasis is a well-recognized complication of indinavir use. |
|
|
Term
|
Definition
| The patient has clinical and laboratory evidence of acute pancreatitis. Common causes of pancreatitis include alcohol, gallstones, and medications. In particular, the nucleoside reverse transcriptase inhibitors used in the treatment of HIV are commonly associated with pancreatitis. Common culprits include tenofovir, didanosine, and stavudine. Treatment of medication-induced pancreatitis includes supportive care, bowel rest, and cessation of the offending agent. |
|
|
Term
| Name one opioid antagonist used in the treatment of constipation? |
|
Definition
| Methylnaltrexone (Relistor®). |
|
|
Term
| Which laboratory finding is most consistent with refeeding syndrome? |
|
Definition
| It is marked by hypophosphatemia, hypokalemia, thiamine deficiency, congestive heart failure and peripheral edema. |
|
|
Term
| what is the main difference between chron's and UC |
|
Definition
| The inflammation of Crohn’s disease is transmural, compared to affecting only the mucosa and submucosa in ulcerative colitis |
|
|
Term
| Question: What breath test is used to determine the eradication of H pylori? |
|
Definition
|
|
Term
| what is more common in diverticulitis ? fever, constipation, N/V. Education is to use high fiber or low fiber diet in acute infx |
|
Definition
constipation. Bowel habits are commonly altered with diverticulitis, with constipation being more common than diarrhea,.
Low fiber |
|
|
Term
| Which of the following is most consistent with a complication that most commonly occurs 6 to 12 weeks after acute hepatitis? |
|
Definition
| Aplastic anemia is a known complication of acute hepatitis. RBC, WBC and Platelets are low |
|
|
Term
|
Definition
| hypercoagulability that accompanies many cancers, and is found on examination as tender migratory thrombophlebitis with Pancreatic CA |
|
|
Term
|
Definition
| palpable nontender gallbladder |
|
|
Term
| which fissure are bad - lateral or medial |
|
Definition
| A lateral anal fissure is concerning for an underlying systemic illness in the patient. Most anal fissures occur in the midline. Fissures that occur in other locations should raise concern for diseases like Crohn’s, HIV, leukemia, tuberculosis or syphilis. |
|
|
Term
| muddy brown cast in urine |
|
Definition
| Acute tubular necrosis. MC type of intrinsic renal failure. cause nephrotoxic agent - Aminoglycosides, MM, Rhabdomyolysis, gout. |
|
|
Term
|
Definition
| Acute tubulointerstitial nephritis. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Adult polycystic kidney dz patient could also have _____ |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibits ADH- tx for SIADH |
|
|
Term
|
Definition
| Epididymitis. Prehn sign is neg in Torsion. |
|
|
Term
|
Definition
| Testicular appendix torsion |
|
|
Term
| acute renal injury after starting ACEI -- what is the underlying cause |
|
Definition
| Renovascular HTN - renal artery stenosis |
|
|
Term
|
Definition
| anticholinergics for bladder -urge incontinence |
|
|
Term
| _________________ is used to diagnose and evaluate disorders of ACTH and cortisol. |
|
Definition
| A cosyntropin test (A) is used to diagnose and evaluate disorders of ACTH and cortisol,. Primary adrenal insufficiency, or Addison's disease, -- first test - serum morning cortisol levels should be measured. |
|
|
Term
| ______________ levels are frequently elevated and is highly suggestive of the diagnosis of pheochromocytoma. |
|
Definition
| Plasma metanephrine levels are frequently elevated and is highly suggestive of the diagnosis of pheochromocytoma. |
|
|
Term
| ______________ levels are frequently elevated and is highly suggestive of the diagnosis of pheochromocytoma. |
|
Definition
| Plasma metanephrine levels are frequently elevated and is highly suggestive of the diagnosis of pheochromocytoma. |
|
|
Term
| higher mortality rate - is it in DKA or Hyperosmolar hyperglycemia |
|
Definition
| hyperosmolar hyperglycemia |
|
|
Term
| 4 drugs that are dopamine agonist used for high prolactine level |
|
Definition
| bromocriptine (A), cabergoline, quinagolide, and pergolide |
|
|
Term
| Hypoglycemia tx for infants. < 1 year old. |
|
Definition
|
|
Term
| Question: What is Conn's syndrome? |
|
Definition
| Excess aldosterone produced by an adrenal adenoma. |
|
|
Term
|
Definition
| is a growth hormone receptor antagonist used in the treatment of acromegaly, a condition of excess, not deficient, growth hormone. |
|
|
Term
| Gaol for LDL for DM and CAD |
|
Definition
|
|
Term
| A1C number for prediabetes |
|
Definition
| Hemoglobin A1C levels of 6.0%-6.5% indicate an increased risk for diabetes mellitus and levels > 6.5% (A) |
|
|
Term
|
Definition
| Ethosuximide, valproic acid. |
|
|
Term
| Reed-Sternberg cells. (Owl eye appearance) |
|
Definition
| Hodgkin lymphoma - is associated with Epstein-Barr virus infection. |
|
|
Term
AGe group for croup and Bac trachieitis
MC bac |
|
Definition
croup 6months-3yr Parainfluenza - send home
Bac tracheitis 3y/o-5y/o S.Aures - Admit for observation - Sick kids |
|
|
Term
| Question: How can you distinguish between bronchiolitis and chlamydial pneumonia? |
|
Definition
| Answer: Chlamydial pneumonia is typically associated with a staccato cough without fever at one to three weeks of age, while bronchiolitis will cause fever |
|
|
Term
|
Definition
| Aortic Coarctation - The classic exam finding is blood pressure higher in the arms than legs, and pulses bounding in the arms and decreased in the legs. Rib notching (inferior aspect of the rib) is the classic radiographic finding in patients with coarctation of the aorta |
|
|
Term
|
Definition
| The appendix testis is a vestigium of the mullerian ductal system. Torsion of the appendix testis is the most common cause of testicular pain in boys 2-10-years-old. |
|
|
Term
| Which of the following is the most common congenital heart defect? |
|
Definition
|
|
Term
| five-year-old boy presents with a progressive rash on his legs and buttocks over the past two days along with intermittent abdominal pain and anorexia. His mother states he has not been as active lately because of pain in his knees and ankles. He was otherwise healthy up until a week ago when he started complaining of intermittent headache and fever which she treated with acetaminophen. Which of the following is a known complication of the patient’s diagnosis? |
|
Definition
| kid has intussusception - but underlying cause is HSP. |
|
|
Term
| A febrile infant with first urinary tract infection should be referred to undergo what other evaluation? |
|
Definition
| Renal and bladder US. Voiding cystourethrography is not recommended any more |
|
|
Term
|
Definition
| Intussusception - Children with high suspicion for intussusception should undergo air-contrast enema, which is both diagnostic and therapeutic. Contraindications to the use of air-contrast enema include hemodynamic instability with shock, free air under the diaphragm, and peritonitis |
|
|
Term
| in BPH - prostate growth is due to |
|
Definition
| This growth is promoted by sex hormones, specifically dihydrotestosterone, as well as cytokines which work by promoting an inflammatory response and promoting epithelial growth factors. |
|
|
Term
| failure to pass meconium within 48 hours of birth, |
|
Definition
| Hirschsprung’s Disease. Dx is made by full thickness rectal bx. MC in down syndrome (tri 21) |
|
|
Term
| Retinal hemorrhages are present in up to 75% of cases and are virtually pathognomonic |
|
Definition
| Abusive head trauma (previously referred to as shaken baby syndrome) i |
|
|
Term
|
Definition
| Clinically, measles is associated with fever, conjunctivitis, coryza, and cough (the 3 Cs). The rash is a discrete red maculopapular rash that first appears on the forehead, becoming coalescent as it spreads down the trunk to the feet. The rash fades in the same head-to-feet pattern as it appeared. Measles is also associated with Koplik’s spots |
|
|
Term
| It is rare in the United States. The incubation period lasts for 2 weeks to 6 months, after which time a painless subcutaneous nodule forms on the penis or vulva. The nodule progresses to a painless ulcer with rolled borders that is highly vascular, giving it the classic “beefy-red” appearance. Due to the vascularity, the lesions bleed easily with contact. |
|
Definition
| Donovanosis, or granuloma inguinale |
|
|
Term
|
Definition
| TOF - name 4 components. central cyanosis and knees to chest improves symptoms. boat shape heart. |
|
|
Term
| this disease - infectivity is greatest in catarrhal stage |
|
Definition
|
|
Term
| kids come with fever, cough, SOB, new murmur, gallap - has chest pain. No IV drug use |
|
Definition
| The most common viral etiologies are enterovirus, adenovirus, parvovirus, EBV, and CMV. Myocardial damage may occur from inflammation and direct damage to the myocardium. This results in ventricular enlargement, poor systolic function, and dilated cardiomyopathy. |
|
|
Term
|
Definition
| Chancroid - painful ulcer |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Meningitis bacteria for <1month old |
|
Definition
Group B strep
Ecoli
Listeria |
|
|
Term
| Meningitis bacteria for 1-24 month old |
|
Definition
Strep pneumo - thats why have to vaccinated
Neiseeria
H influ
This same for 24 and older as well. |
|
|
Term
| What is Erythroblastosis fetalis? |
|
Definition
| Erythroblastosis fetalis is caused by the transplacental passage of maternal antibody active against paternal RBC antigens of the infant and is characterized by an increased rate of RBC destruction that leads to anemia and jaundice in newborn infants. Rh incompatibility |
|
|
Term
| if diaper rash has erythmic plaques and papules tx with ? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| best way to check for renal artery stenosis |
|
Definition
| If the clinical suspicion is high, and renal function is diminished, gadolinium-enhanced magnetic resonance angiography is the test of choice. |
|
|
Term
|
Definition
| Sensation, urinary sphincter and voluntary eye movement |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Guillain barre syndrome is associated with which bacteria |
|
Definition
Campylobacter jejuni.
LP - CSF will show high protein and normal WBC
Tx with plasmapheresis |
|
|
Term
| pyridostigmine is 1st line tx for ? |
|
Definition
|
|
Term
| Edrophonium(tensilon) test dx what |
|
Definition
|
|
Term
| prophylaxis medication for cluster HA |
|
Definition
|
|
Term
| Triad - Dementia, Gait disturbance, Urinary incontinence |
|
Definition
| Normal pressure hydrocephalus |
|
|
Term
| CSF has oligoclonal bands |
|
Definition
|
|
Term
| pediatric maintenance fluid per hr -- 18 kg kid should get how much |
|
Definition
|
|
Term
Most common CNS tumor of pediatrics
and MC in Adults |
|
Definition
Pilocystic astsrocytoma
Glioblastoma |
|
|
Term
| Valporic acid (Depakote) MC side effect |
|
Definition
| pancreatitis hepatotoxicity |
|
|
Term
|
Definition
| Question: Name the condition of lateral femoral cutaneous nerve entrapment under the inguinal ligament. |
|
|
Term
| quetiapine - medication is used for |
|
Definition
| Seroquel - Schizo , bipol and depress |
|
|
Term
|
Definition
| Abilify - Atypical antipsychotic - tx crazy people |
|
|
Term
|
Definition
| sometimes called the barber chair phenomenon, is an electrical sensation that runs down the back and into the limbs. The sensation can feel like it goes up or down the spine. It is generally considered uncomfortable.- MS |
|
|
Term
| Her presentation is classic with the development of a rash, joint pain, and fever a week after beginning antibiotics. |
|
Definition
| This patient has acute serum sickness. |
|
|
Term
|
Definition
Lead poisoning
Question: What is the oral chelation medication for lead poisoning?
Answer: Succimer. - Its succus to eat lead |
|
|
Term
|
Definition
| Schistocytes (D) are fragmented red blood cells caused by shearing with fibrin strands in microarterioles. They are seen on smears in patients with artificial heart valves and in numerous disease processes, including hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, and congestive heart failure. |
|
|
Term
|
Definition
| are inclusions within red blood cells made of denatured hemoglobin. They are seen in glucose-6-phosphate deficiency, liver disease, and alpha-thalassemia. |
|
|
Term
| A 63-year-old man with chronic alcoholism presents with headache, fever and neck pain. Physical examination reveals neck stiffness. What antibiotics should be administered? |
|
Definition
Vanc, roceph, Ampicillin - Listeria. monocytogenes is typically treated with ampicillin. Empiric antibiotic by age:
18 - 50 years: ceftriaxone + vancomycin
> 50 years: ceftriaxone + ampicillin + vancomycin |
|
|
Term
| patient is diagnosed with multiple sclerosis. Imaging shows that the majority of plaques are located in the cerebellum. Examination is positive for dysmetria and ataxia. Which of the following types of tremor would most commonly occur in this patient? |
|
Definition
| An intention tremor is a tremor that occurs during movement that increases as a target is approached. The tremor is associated with cerebellar signs. |
|
|
Term
| _________ are the most common cause of intracerebral hemorrhage in children. |
|
Definition
| Vascular malformations (D), such as arteriovenous malformations and aneurysms, |
|
|
Term
| _________ are the most common cause of intracerebral hemorrhage in Adult |
|
Definition
| Hypertensive vasculopathy, Not Malignant HTN (Second MC) |
|
|
Term
| MC type of child abuse in the US |
|
Definition
| Most states recognize four major types of maltreatment: neglect, physical abuse, psychological maltreatment, and sexual abuse. In the United States, medical providers are mandated reporters of child abuse. Neglect is the most common type of child maltreatment in the United States (78.5%) and is caregiver failure to meet basic nutritional, medical, educational, and emotional needs of a child. |
|
|
Term
| protect the kidney with dose of _________ before IV contrast |
|
Definition
|
|
Term
| ___________ is a chelating agent used in treating hemochromatosis (iron overload) and iron poisoning |
|
Definition
|
|
Term
| ___________ is a copper chelating agent used in the treatment of Wilson’s disease. |
|
Definition
|
|
Term
| _____________is a chelator used in arsenic, mercury and lead poisoning. |
|
Definition
|
|
Term
| Question: What is the reason for amenorrhea when using first generation anti-psychotics? |
|
Definition
|
|
Term
|
Definition
| Blue mark over trigeminal nerve |
|
|
Term
| Different name for Dermal melanosis, |
|
Definition
| also known as a Mongolian spot - blue spot birth mark |
|
|
Term
| benztropine brand name and sue |
|
Definition
| Cogentin - dystonic reaction |
|
|
Term
| What is the minimum age that the influenza vaccination can be administered? |
|
Definition
|
|
Term
| Question: Which disease, caused by lymphatic obstruction, commonly results in chronic hydrocele (elephantiasis)? |
|
Definition
| Answer: Filariasis, a parasitic disease caused by nematodes |
|
|
Term
| risk factors for pyloric stenosis |
|
Definition
| Risk factors include first born, male sex, prematurity, and macrolide antibiotic use. |
|
|
Term
| what is a second line treat for seizure if benzo dont work |
|
Definition
Phenytoin or fosphenytoin
or Valproic acid. or phenobarbital or levetiracetam |
|
|
Term
| what is the third line treatment for seizure if benzo and phenytoin dont work |
|
Definition
| Pentobarbital (Used for chemical execution ) or propofol |
|
|
Term
| albumin-cytological dissociation |
|
Definition
| Elevated protein with only a mild pleocytosis on cerebrospinal fluid analysis (termed albumin-cytological dissociation) is highly specific in the clinical setting of suspected GBS. |
|
|
Term
|
Definition
| rocephin + vanco - MC bacteria H influenza |
|
|
Term
| Different name for pinworm |
|
Definition
|
|
Term
| The PHQ-9 form is used in |
|
Definition
| the evaluation of depression, |
|
|
Term
| Streptococcus Agalactiae different name |
|
Definition
| GBS - MCC of neonatal meningitis |
|
|
Term
| atrophy of the caudate nucleus and putamen of the basal ganglia, and the cerebral cortex. |
|
Definition
|
|
Term
| what is Substance dependence |
|
Definition
| occurs when an individual continues to use a substance despite problems related to the substance, namely tolerance and withdrawal symptoms. This is the usual definition for physical dependence, whereas some use the term substance dependence, or drug addiction, to describe the “continued use despite problems” paradigm. |
|
|
Term
| Loss of anterior horn cells |
|
Definition
|
|
Term
|
Definition
|
|
Term
| cellular pathology - Lewy body |
|
Definition
| Parkinson - Sibstantia Nigra is affected which stores dopamine |
|
|
Term
| Time difference between IgA nephropathy and Post strep glomerulonephritis |
|
Definition
| 24-48 hrs after cold symptoms and 1 week after strep |
|
|
Term
|
Definition
| Wegener's - necrotizing vasculitis |
|
|
Term
| West nile encephalitis - CBC will show |
|
Definition
|
|
Term
| When do you not treat prolong diarrhea with antibiotics |
|
Definition
| Shigla infection causing HUS- it increases toxin |
|
|
Term
| Ristocetin Activity test ?? |
|
Definition
| Gold standard for Von willebrand ds |
|
|
Term
| MC inherited cause of hypercoagulability |
|
Definition
|
|
Term
| Over production of all 3 myeloid cell line |
|
Definition
| polycythemia vera - JAK2 mutation |
|
|
Term
| 80% spherocytes (round RBCs lacking central pallor) hyperchromic microcytosis |
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Definition
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Term
| Question: What is the most common complication of hereditary spherocytosis? |
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Definition
| over production of Black gallstone |
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Definition
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Term
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Definition
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Term
| Heinz bodies in blood cell |
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Definition
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Term
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Definition
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Term
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Definition
| third generation cephalosporin and an agent covering anaerobic bacteria like metronidazole. |
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Term
| Guilliam B syndrome tx with what |
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Definition
| IVIG and plasmapheresis -- Steroids contraindicated |
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Term
| Guillain barree - DTRs are intact or decreased or increased |
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Definition
| Decreased - LMN lesion - CSF would have high protein level |
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Term
| 1st line tx for rocky mountain fever for children |
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Definition
| Doxy for children too . if pregnant then chloramphenicol -(causes gray baby syncrome) |
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Term
| chorea (writhing, purposeless, and uncontrollable movements of the hands) in children |
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Definition
| think strep infection - Acute Rheumatic fever get - ASO titer |
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Term
| . he classic brain noncontrast MRI findings are multiple T2 hyperintensities found most commonly in the periventricular white matter, |
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Definition
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Term
| cytosine-adenine-guanine trinucleotide repeats in the HTT gene. |
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Definition
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Term
| hich of the following is the most common type of migraine headache? |
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Definition
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Term
| difference between hodgkin and non hodgkin |
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Definition
| Non-Hodgkin’s lymphoma (C) is most common in children between two and twelve years of age; |
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Term
| Sickle cell - pediatric pt MCC of sepsis |
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Definition
| S. pneumoniae sepsis: most common cause of death in children |
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Term
| Lidocaine with and w/o dose maximum can be given |
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Definition
| The maximum dose of Lidocaine is 3-5 mg/kg without epinephrine and 5-7 mg/kg with epinephrine (C). |
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Term
| Can 4 y/o be given PPD and all the regular vaccine at the same time |
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Definition
| all vaccinations and placement of the TST today. |
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Term
| Question: What is the most common cardiac manifestation of Lyme disease? |
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Definition
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Term
| 5 year old get Tdap or Dtap. |
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Definition
| Children 7 years of age and older should receive Tdap --- adults get Tdap. DTaP should be administered to children under age 7. |
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Term
| Argyll Robertson pupil - do what test |
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Definition
| PCR - he has syphilis - for Neuro -3rd stage - treatment is with intravenous benzylpenicillin (penicillin G) 3–4 million units every 4 hours continuously for 10–14 days. |
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Term
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Definition
| Tetanus immune globulin (C & D) should be given to patients with an unknown, incomplete or lack of primary tetanus immunization series. |
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Term
| Influenza and egg allergy |
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Definition
| Give it -- very low risk --A 2012 review of data showed that children with egg allergy are not at increased risk of anaphylaxis from the influenza vaccine. Anaphylaxis still may occur, at a rate of 1-10 in a million, similar to those without egg allergies, and is thought to be due to the immunizing agent itself or other residual proteins used in the creation of the vaccine. |
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Term
| what two lab value are abdnormal in Rocky M fever |
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Definition
| hrombocytopenia and hyponatremia. |
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Term
| landscaper with rash on forearm - for 3 weeks. |
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Definition
| think of Sporotrichosis fungal rash - tx with Itraconazole for 6 months. |
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Term
| what dz requre - Treatment with pyrimethamine and sulfadiazine |
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Definition
| cerebral toxoplasmosis - Remember its MC in HIV pt - CT shows ring enhanced mass. |
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Term
| who has higher risk of rabies bat or raccoons |
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Definition
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Term
| What is the most common malignancy in men age 15-35? |
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Definition
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Term
| Koilonychia are spoon-shaped concave nails |
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Definition
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Term
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Definition
| Zinc deficiency is more commonly associated Muehrcke’s lines: paired, narrow, white, transverse bands that reflect abnormal nail bed vasculature |
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Term
SIRS criteria
HR
Temp
RR
PCO2
WBC |
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Definition
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Term
| The first-line treatment for eczema |
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Definition
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Term
| What CSF finding is most sensitive for Lyme meningitis? |
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Definition
CSF - B. burgdorferi antibodies (IgG or IgA) since this is the most sensitive test
CSF PCR (D) is positive in less than half of patients. |
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Term
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Definition
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Term
| Chagas disease, which is caused by the parasite Trypanosoma cruzi --- worse complication of the disease |
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Definition
| Acute myocarditis is a common complication of Chagas disease and may manifest with acute heart failure (as in this example) or arrhythmia (often refractory to rate control). |
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Term
| Is the rotavirus vaccine contraindicated for an infant with a history of intussusception? |
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Definition
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Term
| what absolute contraindication to the measles, mumps and rubella vaccine? |
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Definition
| patients with a history of anaphylaxis to neomycin should not receive it. |
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Term
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Definition
| 55 - 80 y/o and has to have 30 pack year hx does not matter if current smoker |
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Term
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Definition
| Haemophilus ducreyi (A) is the causative agent of chancroid. --Painfull one.. When you get it -- you Do cry (Ducreyi) becz it hurts |
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Term
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Definition
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Term
| Other descending paralysis |
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Definition
| botulism - infant one is Most common |
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Term
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Definition
| Cat scratch ds. 1st line - bactrim then cipro |
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Term
| 1st line tx for genital warts during pregnancy |
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Definition
| Trichloroacetic acid is the first-line therapy for genital warts during pregnancy |
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Term
| poison IVY - moderate to severe |
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Definition
| steroid for 2-3 weeks . 21 days tapper |
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Term
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Definition
| gold standard for malaria dx |
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Term
| which pt population is at greatest risk of getting west nile dz |
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Definition
| The biggest risk factor, by far, for neuroinvasive West Nile disease is advanced age. |
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Term
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Definition
| raised boggy lesion with local hair loss --fungal infx |
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Term
| Schistosoma parasite treatment |
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Definition
| praziquantel 40 mg/kg/day twice daily for one day. |
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Term
| rule of 9 for burn applies to what type of burns |
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Definition
| 2nd and 3rd degree. Do not count superficial 1st deg |
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Term
| screening criteria for AAA |
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Definition
| one-time screening for AAA with ultrasonography is recommended in men aged 65 to 75 years who have a smoking history. |
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Term
| What is the prognostic indicator of a melanoma lesion? |
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Definition
| Answer: Depth of invasion. |
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Term
| describe Category B drugs |
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Definition
| Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women |
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Term
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Definition
| Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. |
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Term
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Definition
| Strep PYOGENES -- Not Strep Epidermidis --that normal |
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Term
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Definition
| wet warming -- put patient in circulating warm water |
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Term
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Definition
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Term
| sulfa drug allergy can take celecoxib |
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Definition
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Term
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Definition
| yes , it could lead to scarring alopecia. |
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Term
| Is it UVA Or UVB causes sunburn |
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Definition
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Term
| sunscreen should have minimum of ___ SPF |
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Definition
| 30. Apply 15mins before getting out in sun. |
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Term
| African trypanosomiasis is spread by |
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Definition
| Tsetse fly. daytime sleepiness followed by nightime insomnia. |
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Term
| Leading cause of CHF in latin America |
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Definition
| Chagas Disease. causes Unilateral periorbital edema . causes cardiomyopathy. |
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Term
| is the presence of one eosinophil in the CSF considered normal or abnormal? |
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Definition
| The presence of even one eosinophil in the CSF is considered abnormal. Be suspicious in such cases of a parasitic infection. |
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Term
| What to avoid in Perioral Dermititis |
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Definition
| STeroid - topical or oral |
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Term
| Urine Eosinophils and serium IgE elevation |
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Definition
| Acute interstiatitial nehritis - WBC cast are pathognomonic |
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Term
| funny looking new born 7 day old is having a seizure - has hypocalcemia - |
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Definition
| The infant has an abnormal facie that presents with seizures, which is suspicious for DiGeorge syndrome. This disorder arises from a failure of migration of neural crest cells into the third and fourth pharyngeal pouches. About 80 to 90 percent of patients with DiGeorge syndrome have microdeletions involving chromosome 22q11. Patients typically present in the first week after birth with signs of hypocalcemia such as tetany or seizures that is secondary to hypoplastic or absent parathyroid glands. |
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Term
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Definition
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Term
| Question: What organism is responsible for hot tub folliculitis in most cases? |
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Definition
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Term
| Which pharmacological treatment was recently approved by the FDA for treatment of inflammatory lesions of rosacea. |
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Definition
| Ivermectin topical cream was approved by the FDA in December 2014. |
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Term
| A maculopapular rash over the trunk following Langers’ lines (D) is the characteristic rash of |
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Definition
| pityriasis rosea - Christmas tree pattern-herald patch |
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Term
| tardive dyskinesia after haloperidol oral dose |
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Definition
| Benztropine (A) and diphenhydramine (B) are effective in treating acute dystonic reactions and akathesia but are not effective in treating TD - so stop haloperidol |
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Term
| recent travel - pt come in with severe myalgia, fever, HA -- what dz |
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Definition
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Term
| Which antiepileptic medication commonly causes hyponatremia at therapeutic doses? |
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Definition
| Oxcarbazepine -- Only oxymorron would that this as hyponatremia would cause seizure |
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Term
| when to order chelation tx for lead? if it is mild then what to do |
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Definition
Treating with chelation (D) is not needed at this point. Chelation is given for lead level greater than or equal to 45.
mild elevated level - take away the exposure |
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Term
| A 30-year-old daycare worker has a 3-day history of arthralgias, malaise, and a rash. The rash is nonpruritic, maculopapular, irregular, and is located on her thighs and inner aspects of her upper arms. Symmetric synovitis is present in her fingers. Small effusions, warmth, and tenderness are noted in her left wrist and right elbow. No other joints are affected. Which of the following is most likely responsible for this presentation? |
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Definition
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Term
| Which of the following is the most common cell type of ovarian cancer? |
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Definition
| ovarian cancer is of epithelial cell origin (90%) |
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Term
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Definition
|
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Term
| PCOS has which GYN hormone elevation |
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Definition
| increased luteinizing hormone (LH) |
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Term
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Definition
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Term
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Definition
| Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation -- tx with erythromycin - Wood lamp test |
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Term
| Pen allergy - ________used to treat Lyme disease in a pregnant patient? |
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Definition
| Cefuroxime axetil, a second-generation oral cephalopsporin. |
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Term
| Anti-Saccharomyces cerevisiae antibodies (ASCAs) |
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Definition
| Cronh's diseaes 70-80% pt has it |
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Term
| Small target lesion which are painful and it is generlized over the body including lips |
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Definition
| erythema multiforme (EM) and should be started on systemic corticosteroids |
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Term
| Which of the following is a risk factor for developing nephrolithiasis? |
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Definition
| think about PUD pt Patients with peptic ulcer disease tend to ingest large amounts of calcium with food, in addition to absorbed alkali sources and antacids. |
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Term
| MC Nephrotic syndrome in adults |
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Definition
| (focal segmental glomerulosclerosis is the most common cause of nephrotic syndrome in adults) |
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Term
| most common cause of mental retardation |
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Definition
| Fregile X - big balls , big Jaw long face |
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Term
|
Definition
|
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Term
| Down syndrome - mc heart defect |
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Definition
|
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Term
| Ehlers Danlos syndrome - common cause of death |
|
Definition
| Aneurysm rupture . they have Smooth velvety doughy fragile skin - easily bruised |
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Term
| Cat Scratch disease treatment |
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Definition
|
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Term
|
Definition
|
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Term
| Erythema multiform is associated with what virus |
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Definition
|
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Term
|
Definition
| 1st line topical tacrolimus |
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Term
| conjunctivitis - newborn age for gono and chlamidiya |
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Definition
New born - 0 -5 days for gono
5-5 weeks - chlamydia |
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Term
| HEmophilia A MC bleeding site for ped population |
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Definition
| However, 80% of hemorrhage occurs in the joints. In children, the most common joint is the ankle. |
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Term
| hemophilia A - MC spontaneous site for adult |
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Definition
| Knee joint then elbow then ankle |
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Term
| thorasic AA - what test is best |
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Definition
|
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Term
| flu like symptoms - fever and chest pain. young does not do IV drugs. dx with myocarditis - source |
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Definition
|
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Term
|
Definition
| Infiltrative ductal Carcinoma . But MC benign tumor is Fibroadenoma |
|
|
Term
| MCC of Pancreatitis in Children |
|
Definition
|
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Term
|
Definition
| klinefelter's syndrome 47 XXY |
|
|
Term
| Ulcerative skin lesion in Ulcerative colitis cronhn or RA |
|
Definition
| Pyoderma Gangrenosum - tx with topical high potency steroid |
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Term
| who attempt and who complete suicide more - male or female |
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Definition
Female attempt more but dose bad job - survive
male does it right - ends it |
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