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 |