PRLS Quick Facts (edited)

What patients should receive prophylactic antibiotics for risk of endocarditis?

-prosthetic heart valves

-previous bacterial endocarditis

-congenital heart disease

-shunts

-indwelling vascular caths

What is the antibiotic used for bacterial endocarditis?

amoxicillin 1 hour before surgery

-adult: 2g

-children: 50mg / kg PO

What rash is a silver scales on a red base seen commonly on extensor surfaces?

psoriasis

What is main treatment for psoriasis?

-TOP corticosteroids

What should never be given for psoriasis?

po steroids

What rash is red papules with non demarcated borders that is commonly lichenified and found on the flexural surfaces?

atopic dermatitis

What is main treatment of atopic dermatitis?

-moisturizers

-PO / TOP corticosteroids

What is a rash that is waxy, greasy yellow scaling found commonly on the scalp, eyelids, NL folds, ear folds, etc?

seborrheic dermatitis

What is the main treatment of seborrheic dermatitis?

-moisturizers

-PO / TOP corticosteroids

What does seborrheic dermatitis the cause of?

dandruff

What rash is diffuse salmon oval patch known as the Herald patch or Christmas tree pattern rash?

pityriasis rosea

What is the main treatment for pityriasis roses?

-TOP corticosteroids

What rash is u/l dermatomal grouped vesicles on a red base?

Herpes zoster

What is the main treatment of herpes zoster? Duration?

PO valacyclovir

1 week

What rash is solitary grouped vesicles on a red base that recoccurs often in the same area?

Herpes simplex

What is the main treatment of herpes simplex? Duration?

PO valacyclovir

1-3 days

or topical valacyclovir

or PO lysine

What rash is pruritic papules post contact with allergen occurring in a pattern?

allergic contact dermatitis

What is the main treatment of allergic contact dermatitis? duration?

-PO or TOP corticosteroids

x 1 - 3 weeks

-PO antihistamines

What rash pruritic papules that are found under the skin?

scabies

What is the main treatment of scabies?

-TO permethrin

-TO Benzyl benzoate

-TO Sulfur ointment

What is the treatment of scabies for children < 6 months?

sulfur ointment

DO NOT GIVE THEM PERMETHRIN

What rash looks like tinea but is not of fungal origin and is brought on by UV exposure?

discoid lupus

What rash is a malar butterfly rash that spares the NL folds?

SLE

What is treatment for SLE/DLE?

-PO or TOP corticosteroids

What rash is scaly pink / red lesion +/- scaling with an active, raised and well demarcated border?

tinea

What is treatment for tinea?

-TOP or PO antifungals (fluconazole, terbinafine)

What rash is subepidermal blistering of the trunk, limbs and flexural surfaces?

bullosus pemphigoid

What is the main treatment of BP?

-PO and TOP corticosteroids

What rash is pruritic slightly tender red papular scaling in contact with chronically exposed areas?

irritant contact dermatitis

What is the treatment for ICD?

-PO or TOP corticosteroids

What rash is erythema and edema that is hot to the touch with advancing borders? What is the pain pathogen?

cellulitis

Staph aureus

What 4 antibiotics are appropriate for cellulitis?

-ceph

-clinda

-tmp/smx

-vancomycin

What rash is bullseye rash / erythema migrans?

Lyme disease

What is the main treatment of Lyme disease?

doxycycline

What rash is erythema, brown/rusty red with scaling, bumpiness and possible weeping?

stasis dermatitis

What is main treatment of stasis dermatitis?

-compression stockings

-TOP corticosteroids

What rash is extremely painful with dusky red, purple, or black skin with edema, odor and pus?

nec fasc

What is the antibiotic regimen (2) of necrotizing fasciitis?

-Debridement

-Ampicillin/Sulbactam + Clindamycin

What skin lesion is a warty, stuck on appearance?

seborrheic keratosis?

What is the treatment of SK?

none

shave removal

LN

What is the main treatment of warts?

None

Liquid Nitrogen

What skin lesion is thin, crust, scab in sun exposured area that is a precancerous lesion?

actinic keratosis

What is the main treatment of AK?

Liquid Nitrogen

(imiquimod, excise)

What skin lesion is a crusted cancerous lesion that is in chronically sunexposed areas?

SCC

What is the main treatment of SCC?

excision

Photoallergy Rashes are:

-UV light + ________ / _________ chemical

-_______ amounts of light

-_________ like

Phototoxic Rashes are:

-UV light + ____________ chemical

-_______ amounts of light

-_________ like

-topical / systemic

-small

-eczema

-systemic

-large

-sunburn

What are the 3 types of photosensitivity rashes?

1. DLE

2. Porphyria Cutanea Tarda

3. Polymorphic Light Eruption

What photosensitivity rash is from a build up of Fe stores and is treated by phlebotomy?

Porphyria Cutanea Tarda

What photosensitivity rash is idiopathic and causes many small inflammatory papules?

Polymorphic Light Eruption

What skin rash is the the Ps (pruritic, purple, papules) with a pattern of Wickham striae?

lichen planus

What is main treatment of lichen planus?

-TOP or PO corticosteroids

What is known as adults acne with many inflammatory papules/redness. It does cross the nasolabial folds and there are 4 types?

rosacea

What is the treatment of rosacea?

topical metronidazole

Where does acute gouty arthritis usually occur?

1st toe MC

What medications can cause gout exacerbation?

-loops

-thiazide

-aspirin

What are tophi?

crystal deposits + inflammation of the joint that is often visible

What is seen on aspiration with gout?

MSU crystals (-) birefringent needle shaped

What may uric acids levels be during an acute gout flare?

NORMAL (draw 2 weeks post flare)

What are 3 treatments for acute gout?

1. NSAIDS

2. CORTICOSTEROIDS

3. COLCHICINE

What are 3 treatments for chronic gout?

1. XOIs (allopurinol)

2. Probenecid

3. Uricase

What can starting gout medication cause?

GOUT FLARES

What is the PSA to refer to urology with BPH?

4 ng/mL

What is the PSA to start of alpha reductase inhibitors with BPH?

1.5 ng/mL

What medication for BPH is good for sx relief?

alpha adrenergic blockers (alfuzosin, tamsulosin)

What medication for BPH is good for decreasing prostate size?

5 alpha reductase inhibitors

(finasteride, dutasteride)

What is the FEV1/FVC ratio for COPD?

< 70% (all stages)

DECREASED

What is the drug of choice for CHRONIC COPD?

1. LAMA

(can do LABA or LAMA + LABA)

What is the drug of choice of ACUTE COPD?

1. SABA (albuterol)

2. SAMA (ipratropium bromide)

3. SABA + SAMA (duoneb)

or

-PO steroids (40 mg x 5-14 days)

-PO abx

-O2

FBG

-normal

-pre diabetes

-diabetes

-< 100

-100-125

-126+

2 hr OGTT

-normal

-pre diabetes

-diabetes

-< 140

-140-199

-200+

HbA1c

-normal

-pre diabetes

-diabetes

-5.7%

-5.7-6.4%

-6.5%+

What is BP goal in patient with T2DM?

< 130 / 80 mmHg

What is LDL goal in patient with T2DM?

< 100

< 70 (with CV RF)

What is ROME IV Criteria for IBS?

recurrent abdominal pain at least 1 day in the last 3 months

+

-related to defecation

-change in frequency

-change in form

What are some medication options for IBS?

-Miralax

-Immodium

-Bentyl

What is the most common G- of acute cholangitis?

E coli

What is the most common G+ of acute cholangitis?

Enterococcus

What is Charot's triad?

RUQ pain, fever, jaundice

What is Reynold's Pentad?

- Charcot's traid

- septic shock

- altered mental status

What is imaging for acute cholangitis?

abdominal US

What liver enzymes are elevated in acute cholangitis?

-direct BR

-GGT

-alk phos

What is the antibiotic cocktail (2) for acute cholangitis?

fluroquinilone / cephalosporins + metronidazole

What are the levels of HTN?

-Normal

-Elevated

-Stage 1

-Stage 2

-normal: < 120/80

-elevated: 120-129/<80

-1: 130-139 / 80-89

-2: >140/90

What is treatment of stage 2 HTN?

double therapy

-ACE/ARB + CCB

OR

-ACE/ARB + thiazide

What is treatment of resistant HTN?

double therapy +

loop / AA / BB / alpha blocker

What is ESI?

emergency severity index, used to determine the significance of an EM complaint

What is the grading system of ESI (1-5 scale)?

1 = need life saving intervention

2 = 2+ resources + unstable

3 = 2+ reproduces + nl vitals

4 = 1 resource

5 = 0 resources

What is diagnostic of intracranial hemorrhage?

CT without contrast

What is diagnostic of ectopic pregnancy in EM?

-bHCG

-US

-CBC and CMP

_________ is imaging to r/o fracture.

x ray

_________ is imaging for soft tissue injury.

MRI w/o contrast

_________ is imaging for tumor, infection, and soft tissue / bone issues.

MRI with contrast

_________ is imaging for bony injury evaluation.

CT w/o contrast

What is pathomneumonic for septic arthritis?

limited / pain with PROM

What ages is screening done for Lead Poising in peds?

12 months

24 months

What level of lead requires a repeat venous draw?

> 5 mg / dL

What level is chelation therapy needed for lead poisoning? What is the medication for chelation?

-> 45 mg/dL

-succimer, penicillamine

What is diagnostic test of choice for retropharyngeal abscess?

CT of neck with contrast

What is antibiotic treatment for retropharyngeal abscess?

augmentin

clindamycin

What are the types of ADHD?

inattentive, hyperactive, combined