STEP 2 250 Rxs Rapid Review

STEP 2: 250 Rxs Rapid Review right before exam. 1-Rx Webs in plummer vinson : dilation 2- Rx Intimal flap of carotid artery: surgey 3- Rx Ant wall MI : risk of arterial thrombo ; full doses heparin + 3 months of warfarin. 4- Rx Acute ill and toxic pt with UC : proctosigmo + biopsy 5- Rx Heat stroke : rapid cooling 6- Rx progressive back pain + myelopathy: IV dexa --> MRI --> Rx Metastatic cord compression : Radiotherapy 7- Rx refractory hydrothorax due to cirrohis : TIPS 8- Rx Ref ascitis : TIPS 9- Rx recurrent variceal bleading not responsive to medical Rx : TIPS 10- Rx TCA poisoning : NaHCO3 11- Rx diabetic cystopathy: 1- oral bethancol , 2- intermittent catheter 12- Rx chlamydia : single dose of Azithromycin OR 7 days doxycyclin 13- Rx neuromalignant syn : Dantrolene or Bromocripten 14- Rx atopic dermatitis : prevention of Rx , take short baths. 15- Rx presbyopia : convex lenses 16- Rx amblyopia : cover better eye 17- Rx hyperopia : convex lenses 18- Rx myopia : concave lenses 19- Rx beta blocker posioning : recent ingestion= emesis , bradycardia : Atropine--> Isoproterenol--> glucagon-->pace 20- Rx beta blocker poisioning : severe bronchospasm : aminophylline or Beta2 agonist. 21- Rx Isolated duodenal hematoma : NG + parentral nutrition. 22- Rx for preventing recurrence of HBV after liver transplant : HBV Ig + Lamivudine. 23- Rx Seizure due to INH toxicity : Pyriodoxine 24- Rx hyponatremia due to SIADH : water restriction. 25- Rx Girl infant < 3 months w vaginal bleeding : observation 26- Rx Slow down progression of DM nephropathy : AceI 27- Rx epiglottitis : Fiberoptic laryngoscopy in OR ( not in ER) 28- Rx acute attacks of migrains : Rizatriptan 29- Rx acute attack of migrains lasts for longer than 48 hours or r frequently recurrent : ergotamine. 30- Rx anorexia nervosa : hospitalization 31- Rx prophlaxy against human bites : Amoxi / calvulanate 32- Rx rhabdomyolysis : osmotic diuresis + bicarbonate 33- Rx Afib + HF : digoxin . 34- Rx acute rejection : high dose IV steroides. 35- Rx bipolar disorder : lithium , valporate, OLANZAPINE. 36- Rx PCP : cotri .

37- Rx PCP + PaO2 no answer --> esophagoscopy + cytology + biopsy 41- Rx psuedotumor cerebri : 1-acetazolamide --> no answer --> 2- shunt. 42- Rx struvite stones : eradication of UT infections. 43- Rx persistantly elevated ALT leval w detectable HBs Ag , HBe Ag and HBV DNA : INF and lamivudine. 44- Rx febrile neutropenic pt : cetazidime or cefepime ( add vanco if pt is hypotensive or there is high suspiscion of MRSA) 45- Rx Isolated systolic HTN: thiazides . 46- Rx acute attack of cluster headaches : 100% oxygen 47- Rx prevention of cluster headaches : verapamil 48- Rx reversing cardiac effects of ca channel blockers : Ca! 49- Rx Viterous hemorrhage : immediate ophthlamo condsultation. 50- Rx Battery in esophagus : remove it immediatly . 51- Rx Battery in intestine : observe it. 52- Rx acute bleeding in pts with liver failure : FFP. 53- Rx OtoSclerosis : Surgery + Sodium Fluoride . 54- Rx non infalm comedones : topical retionides. 55- Rx mild inflam acne : benzoyl peroxide , topical antibiotics. 56- Rx Refractory mania, severe dep , dep in pregnancy , neuroleptic malig synd, catatonic schizo : ECT 57- Rx Acute attack of hepatic encephalopathy : All dietary protein withheld , oral or rectal lactulose , oral NEOMYCIN. 58- Rx white reflex in infant : refer to ophthalmo 59- Rx ST elevation>1 mm in 2 contiguous leads : thrombolytic therapy OR PTCA 60- Rx New LBBB : thrombolytic therapy. 61- Rx Trachoma : ORAL tetra or erythromycin. 62- Rx diabetic nephropathy : protein restriction ( 0.8 g/kg) , don't use AceI if Cr> 2,2.5 63- Rx Zenker : excision and frequently cricophayngeal myotomy 64- Rx porcelain gall bladder : cholecystectomy ( risk of carcinoma) 65- Rx conversion disorder : psychotherapy ( long term benefit ) 66- Rx Dyspepsia w positve breath test : erad H.pylori 67- Rx Dyspepsia w/o positive breath test : H2 blocker / PPI 68- Rx fibromuscular dysplasia : percutaneous angioplasty w stent placement. 69- Rx prophylaxis against MAC : Azithro or clarithro 70- Rx PBC: ursodeoxycholic 71- Rx Orbital cellulitis : imm admin of IV antibiotics. 72- Rx carcinoid synd : can u remove it?( Remove it ) , u can't remove it ? ( use octerotide ) 73- Rx vaginismus : relaxation, Kegel exercise , insertion training. 74- Rx Hypertrophic dystrophy of Vulva : steroides. 75- Rx lichen scleroris : steroides 76- Rx atrophic vaginitis : estrogen

77- Rx stable angina + HTN : Beta blocker. 78- Rx Tremor and rigidity in parkinson : Antichol ( benzotropines) 79- Rx exercise induced asthma : Beta agon , mast cell stabilizer. 80- Rx Reiter syn : NSAIDS . 81- Rx Chronic HCV ( HCV RNA presents , ALT inc , chornic hepatitis of at least moderate grade): INF+ Ribaverin. 82- Rx Lactation Suppression: tight fitting bra , ice packs , analgesics. 83- Rx non-complinat schizophrenic pt : long acting injectable antipsychotics like fluphenazine and haloperidol. 84- Rx TIA due to atherosclrosis: ASA 85- Rx TIA due to emboli from heart : Anticoagulation. 86- Rx Nocardiosis : sulfonamides. 87- Rx prophylaxis of getting UTI after intercourse : voiding after intercourse. 88- Rx met prostate cancer: palliative radiation + anti androgen therapy ( leuprolide ) 89- Rx Actinomycosis : high dose penicillin 90- Rx RA with erosive joint disease : DMARDS ( MTX, hydroxychlorquine , sulfasalazine , etanercept, azathio) 91- Rx Met brain tumor : surgery + whole brain radiation. 92- Rx Dressker : NSAIDS --> no answer : short course of steroides. 93- Rx PMR : low dose pred 94- Rx Giant cell : high dose. 95- Rx cocaine intox : Benzo + ASA + nitrates. 96- Rx effect of PEEP on CO : inotropic agent or fluids. 97- Rx RMSF: Doxycycline 98- Rx De Quervain’s tensosynovitis : Long acting steroids. 99- Rx HSV encephalitis : IV acyclo without delay. 100- Rx ALS: Riluzole 101- Rx Subdural hematoma w/o midline shift : head elevation , hyperventilation , acetazolamide 102- Rx Subdural hematoma w midline shift : craniotomy 103- Rx early syph : Single IM Benz Peni , if allergic Doxy or tetra for 14 days . in pregnancy use peni with desintizator 104- Rx Acute attack of Gout : use NSAIDs, there may be an option of colchicine but do not mark this option. 105- Rx prevention of gout attack : allopurinol 106- Rx GAD: Buspirone 107- Rx post-term preg : NST + BPP ( twice/weekly ) „³ oligo or late dece or >43 w „³ delivery 108- Rx Kawasaki in children : ASA ( the only disease u give child ASA inspite of fear of Reye syn) 109- Rx massive hemoptysis : RIGID broncho 110-Rx acute vaso-occlusive crisis in sicke cell : Exchange transfusion 111-Rx Acute dystonia : antihistamine or anticholinergic 112-Rx Parkinsonism as a result of antipsychotic: Benzo 113-Rx Akathesia : beta blockers

114-Rx HEAVY UNREMITTING ENDO HEMORRHAGE : high dose conjugated estrogens 115-Rx Stress Fx : restricting weight bearing + short leg casts (3 to 4 W) 116-Rx Met breast cancer + lytic bone disease : IV pamidronate 117-Rx intertrochanteric Fx of femur : internal fix with sliding screw and plate , early mobilization 118-Rx Cholangitis : Drain biliary tree with ERCP 119-Rx Lambert Eaton : plasmapheresis + immunosuppression 120-Rx Emphysematous cholecystitis : Imm fluid + electrolyte correction + antibiotics + early surgical cholecystectomy 121-Rx Acute exacerbation of MS: Steroides 122-Rx Umblical hernia : mostly Observe ( look for few indection of intervention) 123-Rx Cholestoma: surgical removal 124-Rx GBS: IVIg, plasmaphresis 125-Rx Hordeoulum/stye : warm compress„³ no answer after 48 hours „³ incision and drainage 126-Rx Erysipelas : Peni 127-Rx Fever in neutropenic pt : Cetazidime / Cefepime 128-Rx MG crisis: plasmapheresis 129-Rx Sarcoidosis : systemic steroids. 130-Rx for prevention of recurrence of renal stone : know them well and also remember that Ca intake must be NORMAL or even INCREASED. 131-Rx Osgood Schlatter disease: Rest, NSAIDs , brief casting 132-Rx Molluscum : curettage or application of luquid nitrogens 133-Rx Amebic liver abscess: metro 134-Rx Hypochlo met alkalo : 0.9% Nacl , NG suction „³ K supp 135-Rx Anorexia asso w chemotherapy : Megestro acetate 136-Rx Tension pneumothorax : needle thoraco 137-Rx Sensory neuropathy w DM : TCA , Gabapentin , NSAIDs 138-Rx acute pyeloneph : IV ampi + genta ( empiric ) 139-Rx VT hemo stable : Lido or Amio 140-Rx prevention of variceal bleeding : beta blocker 141-Rx pul infection if CF : aminoglyco + antipseudomona 142-Rx Hydatid cyst : Surgery under cover of Albendazole ( Plz do not aspirate these cysts ) 143-Rx Reflex sympathetic dystrophy: physical therapy, prednisone , ganglion block 144-Rx Chorioamnionitis :Ampi+ Genta 145-Rx PCO: combines estro/prog or cyclic prog 146-Rx Perforation of esophagus: primary closure of esophagus , drainage of mediastinum w/i 6 hours to prevent mediastinitis 147-Rx Rotator cuff tendonitis : Lido injection 148-Rx Megacolon: Iv fluids , Antibiotics , bowel rest , Iv cortico 149-Rx Disseminated histoplasmosis in HIV: IV ampho B + LIFE LONG itraconazole 150-Rx Pseudomona : cefepim/ceftazidime 151-Rx Dystonia : Anti hista , anti chol 152-Rx AIDS with Dysphagia : 1-2 w of oral fluconazole „³ no answer „³ biopsy

153-Rx Vipoma : correct dehydration slow diarrhea surgery 154-Rx Ewing’s sarcoma : radio/chemo surgery 155-Rx Croup : use racemic epinephrine before intubating your pt. 156-Rx Free air under diaphragm : go to OR 157-Rx Abnormal hemostasis due to uremia : DDAVP, Cryoper, conjugated estro 158-Rx Pancreatic pseudocyst : only drain them if persist more then 6W or > 5 cm. 159-Rx Capillary hemangioma: mostly regress by age of 7 160-Rx Acute torsade de points: Mg replacement 161-Rx MgSo4 tox: stop MgSo4, give Ca gluconate 162-Rx CAD + EF<40% : think about Ace I 163-Rx Dec frequency of relapses of MS: INF beta 164-Rx Anemia of prematurity : Iron supp, periodic Hgb checking and blood transfusion if needed 165-Rx Spinal injuries: think about cortico 166-Rx Ascities in cirrhotic pt : diagnostic paracentesis , salt restricted diet ,spironolactone , 167-Rx Giant cell tumor : refer it to expert! 168-Rx Nocardia : cotri 169-Rx Clavicle Fx : figure of 8 170-Rx “ persistent “ nocturnal enuresis : DDAVP ( not imipiramine , also know which nocturnal is normal ) 171-Rx PCO : think about metformin 172-Rx PH of PF <7.2, PF glucose <60 : chest tube 173-Rx Mediastinal adenopathy on CXR : Med broncho + biopsy 174-Rx bleeding varices : Band ligation is better than sclerotherapy 175-Rx SAH: think about Nimodipine for preventing associated ischemia 176-Rx Tourette’s disorder : Haloperidol , pimozide 177-Rx Preventing PCP in transplant pt : cotri 178-Rx ANY gun shot wound to Ant Abd : LAPARATOMY 179-Rx first line for HTN: diuretics/beta blocker 180-( this one is imp) Rx Primary Parathyro : - pt symptomatic : Surgery , Pt pregnant : surgery, follow up is difficult : surgery , serum Ca > 1 mg/dl over upper limit : surgery 181-Rx Basal cell carcinoma : excision removal with “ 1-2 mm” clear margin ( number is imp) 182-Rx erythema margins ( lyme) Doxy / 28 days or Amoxi ( in pregnant ) 183-Rx Late lyme disease : IV ceftriaxone 184-Rx Irregular atherosclerotic lesion in carotid + blockage >60% : surgery 185-Rx infant with congenital diaphragmatic hernia : IMMEDIATE orogastric tube . 186-Rx Reye syn: glucose + FFP and mannitol to dec cerebral edema 187-Rx Cat Scratch disease: Azithro/5days 188-Rx pt with variceal bleeding needs 5 or more units of blood in 24 hours : go for TIPS 189-Rx intermittent claudication :as pharm therapy go for Ca channel blockers. 190-RX initial drugs in COPD : antichol 191-Rx Isolated LV diastolic dysfunction : beta blocker 192-Rx Colles FX: closed reduction + casting

193-Rx pul emboli with hemo instability or clot in main pul A. : pul embolectomy 194-Rx in ARDS : think about PEEP 195-Rx preg pt w asymptomatic bacteriuria : nitrofuran / 7-10days 196-Rx infectious mono w upper airway obstruction or “ autoimmune hemolytic anemia “ or “ thrombocytopenia “ : cortico 197-Rx Fibromyalgia : TCA or Cylobezarpine 198-Rx Benign essential tremor : propranolol 199-Rx Superficial thrombophlebits : Local heat, bed rest, NSAIDs . 200-Rx Atypical mycobacterium infection : Azithro for prophylaxis 201-Rx MAC: Clarithro + ethambutol ( imp) 202-Rx child w legg calve perthes below 5 years of age : NO TREATMENT!!! 203-Rx child w legg calve perthes above 5 years of age: abduction bracing / surgery 204-Rx IE in IV abusers : Vanco + Genta 205-Rx IE in Non-IV abusers : Nafi + Genta 206-Rx condylomata acuminate: Podophyllin 207-Rx specific phobia : systemic desensitization 208-Rx Tricho : metro for pt + partner 209-Rx ALL pts w BLUNT trauma to abd BUT w signs of peritoneal irritation : laparatomy. 210-Rx slowing cognitive decline in Alz : Donepezil / Tacrine 211-Rx Pancreatic Abscess : “ External “ drainage 211-Rx Pancreatic Abscess : “ External “ drainage 212-Rx Granulum Inguinale : Tetra/10-21 days 213-Rx Pertusis : erythro/14 days 214-Rx Pancoast syn: radiation followed by surgery 215-Rx Acute otitis media: Amoxy /10 days , failed Amoxi-Clav 216-Rx Measles : don’t forget Vit A 217-Rx chest tube drainage of blood more than 1500cc at first or more than 600cc in 6 hours : surgical thoracotomy 218-Rx RV infarction : immediate volume expansion , failed …Dobutamine 219-Rx Vomiting due to chemotherapy: Ondansetron 220-Rx Adjustment disorder: psychodynamic psychotherapy or brief cognitive psychotherapy 221-Rx Legionella pnumo: high dose erythro or azithro 222-Rx CLL ( w associated symp) : chlorambucil/pred 223-Rx first degree heart block: no Rx! 224-Rx Non displaced scaphoid Fx : cast immobilization of wrist 225-Rx Displaced scaphoid Fx : Internal fixation 226-Rx premature atrial beats: No RX! 227-Rx Hairy cell leukemia : Cladribine 228-Rx Non-Hodgkin’s lymphoma: CHOP 229-Rx SVC obstruction: Angioplasty w stenting ( imp) 230-Rx Mediastinitis : Thoracotomy for debrid,drain + antibiotic therapy 231-Rx displaced femoral neck in “ elderly” : primary arthroplasty

232-Rx clavicle Fx in infant : no Rx, avoid putting pressure on arm 233-Rx PID in hospitalized pt : cefoxitin/doxy , cefotetan/doxy, clinda/genta 234-Rx PID in non hos pt: cefoxitin/probencid, cetraixone/doxy 235-Rx Androgen insensivity syn: Gonadectomy ( inc risk of test cancer) 236-Rx compartment syn due to eschar of burn wounds: escharotomy 237-Rx Papilloma of breast : Galactogram guided resection 238-Rx shaft of femur Fx: closed intermedullary fixation w/o interrupting skin. 239-Rx scoliosis < 20 degree: observe 240-Rx scoliosis >30: Bracing. 241-Rx Scoliosis >40: surgery 242-Rx Shaft of humerus: closed reduction + hanging cast . 243-Rx dirty looking wound in pt w less then 3 doses of tet tox: toxoid +Tig ( only situation which u give pt Tig) 244-Rx uncomplicated Basilar skull fx : head elevation , fluid restriction. 245-Rx Ludwig Angina: IV peni w coverage for anaerobes 246-Rx Meconium plug syn : Water soluble contrast enema 247-Rx Ovarian torsion : surgery 248-Rx Tubo-ovarian abscess: surgery 249-Rx volvulus or malrotation: immediate surgery 250-Rx Transposition of great vessels : keep ductus arteriosus open, go for surgery.