Summary: Step 2

Read the summary and the most important questions on STEP 2

• Internal Medicine

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• Management of uncomplicated cystitis

  Trimethoprim-sulfa (3 days), nitrofurantoin (5 days), or fosfomycin (single dose)
  Get urine culture only if fail initial treatment

• What is complicated cystitis and how is it treated?

  Cystitis with factors that increase risk for antibiotic resistance, such as diabetes, CKD, pregnancy, immunocompromise, UTI, hospital-acquired infection, or infection associated with a procedure or indwelling foreign body.
  Get urine culture prior to treatment.
  Treat with fluoroquinolones in stable patients or IV ceftriaxone in severe cases.

• Symptoms and complications of giant cell arteritis

  Headache, jaw claudication, muscle fatigue, vision loss, scalp tenderness, aortic aneurysm

• Warfarin-induced skin necrosis

  Pain, followed by bullae formation and skin necrosis. Typically on breasts, buttocks, thighs, and abdomen. Administer vitamin K and give heparin until lesions heal.

• Treatment of primary Raynaud's

  Avoid aggrevating factors (cold, stress)
  Calcium channel blockers (nifedipine, amlodipine)

• What is secondary Raynaud's phenomenon?

  Etiologies: Connective tissue disease, Occlusive vascular conditions, sympathomimetic drugs, vibrating tools, hyperviscosity syndromes, nicotine
  Presentation: Usually men >40, symptoms of underlying disease, tissue injury or digital ulcers, abnormal nail fold capillary examination

• Treatment of torsades de pointes

  Unstable patients: Defibrillation
  Stable patients: IV magnesium sulfate, correct underlying cause of QT prolongation

• Beck's triad of cardiac tamponade

  Hypotension, elevated JVP, and muffled heart sounds

• What is pyoderma gangrenosum?

  A neutrophilic ulcerative skin disease that forms an expanding, painful ulcer
  Often triggered by trauma
  Usually in individuals with a systemic disorder (eg. autoimmune disease or leukemia
  Diagnose with skin biopsy
  Treat with corticosteroids

• What areas are the most vulnerable to ischemic colitis?

  The splenic flexure and the recto-sigmoid junction