Treatment of Choice in Medical

huge list of treatment of choice in medicine, surgery & other subjects...







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<70 mmhg: cotri + steroides.
38- Rx Bebesiosis : ( quinine, clinda) or ( atovaquone , azithro)
39- Rx IlleoIlleal intussuception due to HSP : Surgery ( in contrast to other causes of intuss )
40- Rx esophagitis in HIV: itraconazole --> 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