USMLE Step 2 Review 18 10 Drugs of Choice Measles in Children

USMLE Step 2 Review 18 10 Drugs of Choice Measles in Children

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Let’s start our USMLE Review with Drugs of Choice from the Gold Standard USMLE Step 2 Audio Review program.

Play USMLE Audio MP3 18 10 Drugs of Choice Measles in Children Below

 Begin 18 10 Drugs of Choice Measles in Children Transcription

While there is no specific treatment recommended for measles in children, 1 study showed a decrease in severity with the administration of a vitamin.

What vitamin, at what dosage, has been shown in 1 study to lessen the severity of measles in children?

  • Vitamin A at 200,000 Units PO for 2 days.

In the treatment of GERD (Gastro-Esophageal Reflux Disease), there are 3 strategies employed without a clear consensus on drug of choice. The first strategy is avoidance of certain foods and raising the head of the bed by 6″.

What foods should be avoided?

  • Chocolate, coffee, peppermint and spearmint, fatty foods, tomatoes, and onions.

Now, given that these are difficult foods to avoid, and considering that tomatoes and onions in particular should be part of a healthy diet especially tomatoes for men (since this has been shown in epidemiological studies to reduce the risk of prostate cancer), there are 2 drug strategies that may be more practical. The first is to tighten the esophageal sphincter and promote rapid emptying of the stomach.

What 2 prokinetic drugs are used for this purpose?

  • Metoclopramide and Cisapride.

And what’s the trade name for Metoclopramide?

  • Reglan.

And the trade name for Cisapride?

  • Propulsid.

What are the 2 prokinetic drugs by trade name?

  • Reglan and Proplulsid.

These 2 drugs should not be used with many antifungal drugs such as Ketoconazole.

What is the side effect?

  • Prolonged QT interval.

The second strategy is to reduce gastric acid. What is the class of drugs that has a milder effect on lowering gastric acid, has to do with the stomach’s reaction to food intake, and is now available in some forms over the counter?

  • The H2 blockers.

And what are the 4 commonly used H2 blockers?

  • Ranitidine, Cimetidine, Famotidine, and Nizatidine.

And the trade name for Ranitidine?

  • Zantac.

And the trade name for Cimetidine?

  • Tagamet.

The trade name for Famotidine?

  • Pepsid.

And the trade name for Nizatidine?

  • Axid.

What are the 4 commonly used H2 blockers by trade name?

  • Zantac, Tagamet, Pepsid, Axid.

Now, the H2 blockers are sometimes insufficient. What stronger class of drugs acts to block the production of gastric acid at all times?

  • The proton pump inhibitors.

And what is the enzyme that is being inhibited?

  • The H+/K+ ATPase.

What are the 2 commonly used proton pump inhibitors?

  • Omeprazole and Lanzoprezole.

Trade name for Omeprazole, which by the way, is recommended by some as the drug of choice for GERD?

  • Prilosec.

And the trade name for Lansoprazole?

  • Prevacid.

What are the 2 commonly used proton pump inhibitors by trade name?

  • Prilosec and Prevacid.

What is the symptomatic problem in Zollinger-Ellison Syndrome?

  • Excessive gastric acid.

What is the usual cause of the excessive gastric acid secretion in Zollinger-Ellison Syndrome?

  • A gastrin-producing tumor of the pancreas.

What are the 2 commonly used proton pump inhibitors by trade name?

  • Prilosec and Prevacid.

What cells of the pancreas produce gastrin?

  • Delta cells.

While any of the H2 blockers or proton pump inhibitors may be used in Zollinger-Ellison syndrome, there is 1 that is probably the drug of choice. Which is it?

  • Omeprazole.

And the trade name for Omeprazole?

  • Prilosec.

What is the drug of choice for cadmium poisoning?

  • EDTA.

And the trade name for EDTA?

  • Calcium Disodium Versenate.

What type of metal poisoning is EDTA/ Calcium Disodium Versenate the second line treatment for, after Succimir/Chemet?

  • Lead poisoning, especially in adults.

In the immunocompromised host, with CMV colitis or esophagitis, what are the 2 drugs of choice alternatives for IV administration for both treatment of the acute phase and maintenance treatment after for Cytomegalovirus colitis or esophagitis?

  • Ganciclovir or Foscarnet.

And the trade names for Ganciclovir and Foscarnet?

  • Cytovene and Foscavir.

What is the permanent cyclooxygenase inhibitor which is used in the risk reduction of stroke, heart attack, risk reduction of colon cancer, and treatment of various aches, pains, and fevers, but must not be used in children?

  • Acetylsalicylic Acid, or Aspirin.

In children, from birth to 5 days old, bronchiolitis is most likely to be caused by what kingdom of organism?

  • Viruses.

What auscultated sign usually accompanies viral bronchiolitis in these infants from birth to 5 days?

  • Expiratory wheezing.

Now, what is the mainstay of treatment, and what is usually not indicated?

  • Oxygen is the mainstay, and antibiotics usually not indicated.

What virus causes viral bronchiolitis 50% of the time in infants 5 days and under?

  • RSV- Respiratory Syncytial Virus.

What virus is involved 25% of the time?

  • Parainfluenza virus.

When the viral bronchiolitis caused by any virus becomes severe and life-threatening, what antiviral may be indicated?

  • Ribavirin.

And how is Ribavirin administered?

  • It’s aerosolized via the respirator.

And the trade name for Ribavirin?

  • Virazole.

Viral bronchiolitis is common within what larger age range in the infant?

  • Birth to 12 months.

Is bacterial superinfection common in this population?

  • No, it is not.

Bronchitis is also usually viral, within what age range?

  • Birth to 5 years old.

What virus most often causes bronchitis under 2 years of age?

  • Adenovirus.

What 2 viruses, the same as for bronchiolitis, most often cause bronchitis ages 2 to 5?

  • RSV and parainfluenza.



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