Asthma: Clinical (To be retired)

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Asthma: Clinical (To be retired)

Medical and surgical emergencies

Cardiology, cardiac surgery and vascular surgery

Advanced cardiac life support (ACLS): Clinical (To be retired)

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Pericardial disease: Clinical (To be retired)

Valvular heart disease: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Shock: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Cholinomimetics: Direct agonists

Cholinomimetics: Indirect agonists (anticholinesterases)

Muscarinic antagonists

Sympathomimetics: Direct agonists

Sympatholytics: Alpha-2 agonists

Adrenergic antagonists: Presynaptic

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Loop diuretics

Thiazide and thiazide-like diuretics

Calcium channel blockers

cGMP mediated smooth muscle vasodilators

Class I antiarrhythmics: Sodium channel blockers

Class II antiarrhythmics: Beta blockers

Class III antiarrhythmics: Potassium channel blockers

Class IV antiarrhythmics: Calcium channel blockers and others

Positive inotropic medications

Antiplatelet medications

Dermatology and plastic surgery

Blistering skin disorders: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Burns: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Parathyroid conditions and calcium imbalance: Clinical (To be retired)

Adrenal insufficiency: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Insulins

Mineralocorticoids and mineralocorticoid antagonists

Glucocorticoids

Gastroenterology and general surgery

Abdominal pain: Clinical (To be retired)

Appendicitis: Clinical (To be retired)

Gastrointestinal bleeding: Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Inflammatory bowel disease: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Gallbladder disorders: Clinical (To be retired)

Pancreatitis: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Hernias: Clinical (To be retired)

Bowel obstruction: Clinical (To be retired)

Abdominal trauma: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Blood products and transfusion: Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Anticoagulants: Heparin

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Thrombolytics

Infectious diseases

Fever of unknown origin: Clinical (To be retired)

Infective endocarditis: Clinical (To be retired)

Pneumonia: Clinical (To be retired)

Tuberculosis: Pathology review

Diarrhea: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Meningitis, encephalitis and brain abscesses: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Antituberculosis medications

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anthelmintic medications

Antimalarials

Anti-mite and louse medications

Nephrology and urology

Hypernatremia: Clinical (To be retired)

Hyponatremia: Clinical (To be retired)

Hyperkalemia: Clinical (To be retired)

Hypokalemia: Clinical (To be retired)

Metabolic and respiratory acidosis: Clinical (To be retired)

Metabolic and respiratory alkalosis: Clinical (To be retired)

Toxidromes: Clinical (To be retired)

Medication overdoses and toxicities: Pathology review

Environmental and chemical toxicities: Pathology review

Acute kidney injury: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Seizures: Clinical (To be retired)

Headaches: Clinical (To be retired)

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Spinal cord disorders: Pathology review

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Migraine medications

Osmotic diuretics

Antiplatelet medications

Thrombolytics

Opioid agonists, mixed agonist-antagonists and partial agonists

Opioid antagonists

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Acute respiratory distress syndrome: Clinical (To be retired)

Pleural effusion: Clinical (To be retired)

Pneumothorax: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Assessments

Asthma: Clinical (To be retired)

USMLE® Step 2 questions

0 / 7 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 12-year-old boy is brought to the clinic due to recurrent episodes of dyspnea and wheezing over the past several weeks. The patient came to the clinic 3 months ago and was diagnosed with intermittent asthma. He was prescribed an albuterol inhaler and instructed to use it as needed. The patient’s parent states the patient uses the inhaler several times per day and has found mild relief. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 14/min, blood pressure is 110/76 mm Hg, and oxygen saturation is 99% on room air. The patient is resting comfortably. Physical examination reveals scattered wheezes on chest auscultation. Which of the following drugs should be added to this patient’s treatment regimen?  

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Tanner Marshall, MS

Asthma is an episodic, chronic respiratory disorder characterized by airway obstruction caused by inflammation and hyperresponsiveness of the bronchial smooth muscle. The two golden words in asthma are “reversible”, which means the obstruction can virtually disappear with medications like bronchodilators, and “inducible”, which means the obstruction can occur in response to a variety of stimuli; including allergens like house dust mites, pet animal dander, like cat dander, and pollen, or irritants like tobacco smoke, respiratory tract infections, like a common cold or pneumonia, cold or dry air, and even emotional stress. Now, atopy is the genetic predisposition of an individual towards developing IgE antibodies to otherwise harmless environmental antigens, making that individual strongly predisposed to developing three allergic disorders, eczema or atopic dermatitis, allergic rhinitis, and asthma, collectively coined the atopic triad. Because of this genetic component, asthma is usually diagnosed in early childhood, and may or may not carry on into adulthood.

So, let’s say a genetically predisposed child is exposed to a potential allergen for the first time. First off, dendritic cells take up the allergen and present it to a type 2 helper T-cell, or Th2 cell. In asthma, Th2 cells make the mistake of thinking this harmless antigen is an allergen, so they release cytokines that stimulate B cells to make IgE antibodies. IgE antibodies then prime mast cells, which cautiously anticipate the next event. When the child is re-exposed to the allergen, the mast cells spill out vasoactive mediators like histamine and leukotrienes, which cause bronchoconstriction and inflammation. Once the child is no longer exposed to the allergen, the immune system relaxes, and everything goes back to normal, until the next event. Now, not all asthma episodes are triggered this way by an allergen. A unique form of asthma is aspirin sensitive asthma, which is characterized by the triad of asthma, nasal polyps, and sensitivity to aspirin or NSAIDs. Aspirin opposes prostaglandin production and tips the balance between prostaglandins and leukotrienes in favor of increased leukotriene production, which promotes smooth muscle contraction of the airways.

Elsevier

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