| Actinic Keratosis | Tx:
–Cryosurgery
-Topical 5-FU
-Topical Imiquimod |
| Acute bacterial diarrhea | Avoid Loperamide |
| Asthma | Tx:
-Supplemental oxygen
-PO/IV steroids
-Bronchodilators |
| Atopic Dermatitis | Tx:
-Topical steroids, UV light |
| Bariatric Surgery | Treat stomal stenosis (dumping syndrome):
–Small meals with high protein |
| Basal Cell Carcinoma | Dx: full thickness excisional bx
Tx: Excision w/3-5mm margin or Mohs |
| Bite | Dog/Cat bite:
-Pasturella multicoda
Human bite:
HACEK
Tx:
Amoxicillin-Clavulanate
Note: HIV and Hepatitis B prophylaxis for human bite |
| Blood Transfusion | Indication: Hb <7 |
| Boerhaave syndrome | Dx:
–Gastrograph and swallow (shows dye extravasating out of esophagus) |
| Breast Cancer | Risk Factor:
1. Age |
| Cellulitis | Bug: Staph aureus (purulent), GAS (non-purulent)
Dx: clinical, may culture, MRI to r/o bone involvement
Tx: oral cephalexin, dicloxacillin, or clindamycin – may consider IV if real bad |
| Cholesterol | Decrease Triglycerides: Fibrates
Best to increase HDL: Niacin |
| Chronic Heart Failure | Decrease Mortality:
-B-blocker (carvedilol, metoprolol succinate, bisoprolol)
-ACE-i
-Spironolactone
-Sacubitril/valsartan (Entresto)
-SGLT-2 Inhibitors |
| Chronic Kidney Disease | #1 cause of death: CVD |
| Chronic venous insufficiency | Px:
–Medial malleolus ulcer |
| COPD classifications | Mild: FEV1 >80% = SABA
Moderate: 50-80% = LABA
Severe: 30-50% = ICS
Very severe: <30% = Supplemental Oxygen (Indications: PaO2 <55, SaO2 <88%)
Tx:
-Supplemental oxygen
-PO/IV steroids
-Bronchodilators
Note: Only COPD gets antibiotics |
| Coronary Artery Disease | TIMI score: determine if UA and STEMI need Cath |
| Dermatitis herpetiformis | Tx: Dapsone |
| Diverticulitis | Px:
-LLQ pain
-Constipation
-Fever
-Leukocytosis
Dx:
Abdominal CT
Tx:
-Metronidazole (flagyl)
-Fluoroquinolones (Cipro) |
| Erythema Multiforme | Bugs: HSV, hepatitis, mycoplasma, Yersinia
Tx: abx & NSAIDs |
| Fibromyalgia | Tx:
Amitriptyline |
| Folliculitis | Bug: staph, strep, gram neg
Dx: clinical
Tx: topical abx mupirocin (I&D if develops into carbuncle/furuncle) |
| GERD | Px:
-Dysphagia
-Microcytic anemia
-Weight loss |
| Gout | Acute Gout:
-NSAID (indomethacin, colchicine)
-Intra-articular steroid (if renal disease)
Gout ppx:
-Allopurinol (if urine uric acid is high)
-Probenecid (if urine uric acid is low) |
| Huntington Disease | Tx: Tetrabenazine |
| Hypercalcemia | Elevated calcium > 10
Normal calcium level (8-10)
1st line: IV fluids |
| Hyperkalemia | Tx:
-Calcium gluconate
-Insulin |
| Hyperglycemia | hypertonic hyponatremia |
| Hyperparathyroidism | -Methimazole
-Propylthiouracil |
| Hypertension | Tx:
1st line:
-ACE-i (MOA in kidney: Vasodilation of efferent arteriole)
-CCB
-Thiazides |
| Hyponatremia | Normal serum osmolarity: 275-295
Eq serum osmolarity: 2Na+ + Glucose/18 + BUN/3
Hypertonic hyponatremia: Hyperglycemia
Isotonic hyponatremia: Elevated protein and fat
Hypotonic hyponatremia, hypervolemic:
-CHF
-Cirrhosis
-CKD
Hypotonic hyponatremia, euvolemic:
-Primary polydipsia
-SIADH
Tx: Fluid restriction
Hypotonic hyponatremia, hypovolemic:
-Vomiting
-Diuretics
Tx:
–Normal saline
-Severe and symptomatic: Hypertonic saline 3% |
| Impetigo | Bug: nonbullous (GAS or staph) or bullous (staph)
Dx: clinical
Tx:
-mild: topical mupirocin or retapamulin
-severe: oral cephalexin or dicloxacillin
-MRSA: bactrim, clindamycin or doxycycline |
| Joint | septic: >50k WBC
inflammatory: <50k WBC |
| Mastitis | Tx:
–Dicloxacillin |
| Meinere’s disease | Px:
-Tinnitus
-Hearing loss
-Vertigo |
| Meningitis | MC causes:
-S. pneumoniae
-H. influenzae
-Neisseria meningitis
Tx:
-Ceftriaxone
-Vancomycin |
| Myocardial Infarction | Decrease Mortality:
-B-blocker
-ACE-i
-Aspirin
Indications for LHC:
-STEMI
-New left BBB with symptoms of MI |
| Nausea | Pregnancy:
Dietary changes- small frequent meals, don’t get hungry, don’t get too full, avoid high sugar and high fat, ginger and mint may help
Medication: vitamin B6 (pyridoxine) |
| Nodule | Hyperthyroid nodule: benign
Next step: Radioactive iodine uptake study
Euthyroid nodule: malignant
Next step: FNA (Note: If >1 cm) |
| Osteopenia | DEXA: -1 to -2.5 |
| Osteoporosis | DEXA: <-2.5
Risk Factor:
1. Age |
| Otitis Externa | MC cause: Pseudomonas
Tx:
–Alcohol-acetic acid ear drops
-Addition of corticosteroids to dilution May be beneficial
-Other agents: neomycin, polymyxin B, ciprofloxacin |
| Pancreatitis | MC cause:
-Gallstones
-Alcohol |
| Pancreatic Cancer | Courvoisier’s sign:
-Painless jaundice
-Palpable gallbladder |
| Peritonsillar abscess | Px: Uvular deviation |
| Pilonidal cyst | Bug: folliculitis w/repetitive trauma = staph, strep, Gram Negs
Dx: clinical
Tx: I&D – sterile packing of wound w/good hygiene and shaving of skin to prevent
Note: aka sacrococcygeal abscess |
| Polyp | Most dangerous: Villous |
| Pregnancy Term | Term: 37-42 weeks
Post Term: >42 weeks |
| Pneumonia | Typical PNA MC:
-S. pneumoniae
-H. influenzae
-M. catarrhalis
Atypical PNA MC:
-Mycoplasma
-Chlamydia
-Legionella
Legionella pneumonia:
-Diarrhea
-Hyponatremia
Aspiration PNA:
-Piperacillin-Tazobactam
-Clindamycin
Adm for PNA: >2 on CURB-65 |
| Polyneuropathy | Tx: Duloxetine, pregabalin, gabapentin, amitriptyline, nortriptyline |
| Rhabdomyolysis | Blood on urine dipstick without RBC on microscopic analysis |
| Rheumatoid Arthritis | #1 cause of death: CVD |
| Ring Enhancing Lesions | -Primary CNS lymphoma
-Toxoplasmosis
-Brain abscess |
| Sinusitis | -S. pneumoniae
-H. influenzae
-M. catarrhalis |
| Squamous Cell Carcinoma | Dx: punch or excisional bx
Tx: surgical excision or mohs |
| Stroke | Risk Factor:
1. Hypertension |
| Tinea | Bug: trichophyton, microsporum, and epidermophyton species
Dx:
tinea corporis, capitis, unguium, pedis or cruruis = KOH prep shows hyphae, may do woodlamp to confirm microsporum over trichophyton
Tx:
Corporis – topical miconazole/ketoconazole
Capitis – PO griseofulvin
Unguium – PO terbinafine, griseofulvin, -azole
Pedis – Topical antifungal
Cruris – Topical antifungal |
| Tinea versicolor | Bug: malassezia furfur
Dx:
–KOH prep shows spaghetti & meatballs
Tx:
–topical ketoconazole and selenium sulfide, or oral azole |
| Ulcerative Colitis | Assoc:
-CRC
-Toxic megacolon
-Primary sclerosing cholangitis |
| Umbilical Hernia | Tx: Reassurance |
