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First Aid for the USMLE Step 1 (2021) | Physician Assistant (PA) School Study Aid


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35 Picmonics to Learn | 57 mins

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Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly inhibits COX
Acts primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
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33 secs
Acetylcholinesterase Inhibitor Poisoning
DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Emesis
Lacrimation
Salivation
Sweating
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2 mins
Acetylcholinesterase Inhibitor Antidote
Antidote
Atropine
Pralidoxime
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59 secs
Atropine
Indications
Blocks DUMBBeLSS
Bradycardia
Side Effects
Skin Flushing
Increased Temperature
Dry Mouth
Cycloplegia
Disorientation
Mydriasis
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1 min
Antimuscarinic Antidote
Antidote
Physostigmine Salicylate
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44 secs
Arsenic, Gold and Copper Antidotes
Toxic Metals
Arsenic
Gold
Copper
Antidotes
Penicillamine
Dimercaprol (BAL)
Succimer
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2 mins
Benzodiazepines Overview
Indications
First Line for Status Epilepticus
Anesthesia Induction
Anxiety
Eclampsia
Detoxification
Mechanism of Action
'-zepam' and '-zolam" Suffix
Increase Frequency of Cl- Channel Opening
Side Effects
Decrease REM Sleep
CNS Depression
Dependence
Antidote
Flumazenil for Overdose
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2 mins
Benzodiazepine Antidote
Antidote
Flumazenil
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39 secs
Systemic Effects of Beta-Blockers
Respiratory
Bronchoconstriction
Metabolic
Decreased Insulin
Decreased Glycolysis and Lipolysis
Eye
Reduces Intraocular Pressure
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1 min
Cyanide Poisoning: Pathophysiology and Clinical Manifestation
Pathophysiology
Inhibits Complex IV of Oxidative Phosphorylation
Forces Cells Into Anaerobic Metabolism
Presentation
Exposure to Fire Fumes
Industrial Exposure
Headache and Confusion
Arrhythmias
"Cherry Red" Skin
Almond Breath/Taste
Acute Renal Failure
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4 mins
Cyanide Poisoning Diagnosis and Treatment
Lab Findings
Lactic Acidosis
Elevated Venous PO2
Check Carboxyhemoglobin
Management
Sodium Nitrate PLUS Sodium Thiosulfate
Methemoglobinemia
OR Hydroxocobalamin (First Line)
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4 mins
Acute Digoxin Toxicity
Clinical Symptoms
Hyperkalemia
Cholinergic (Nausea, Vomiting, Diarrhea)
Blurry Yellow Green Vision with Halo of Light
Arrhythmia
Bradycardia
EKG Changes
Prolonged PR interval
Decreased QT
Scooping on EKG
T Wave Inversion
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2 mins
Digoxin Toxicity Treatment
Activated Charcoal
Slowly Normalize K+
Digibind (Anti-Digoxin Fab)
Magnesium Sulfate
Lidocaine
Cardiac Pacing
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2 mins
Factor Xa Inhibitors
Characteristics
Inhibit Factor Xa
-xaban
Drugs
Apixaban
Rivaroxaban
Indications
Pulmonary Embolism
Nonvalvular Atrial Fibrillation
Deep Vein Thrombosis
Considerations
Andexanet Alfa
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2 mins
Heparin Mechanisms
Mechanism of Action
Short Half-life
Antithrombin Activation Cofactor
Decrease Thrombin, Factor Xa
Side Effects
Bleeding
Heparin Induced Thrombocytopenia (HIT)
Antidote
Protamine Sulfate
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2 mins
Enoxaparin (Lovenox)
Mechanism of Action
Inhibits Clotting Factors
Factor Xa
Indications
Clot Formation Prevention
Side Effects
Heparin Induced Thrombocytopenia (HIT)
Bleeding
Considerations
Medication Education
Subcutaneous Injection
2 Inches from Umbilicus or Incisions
Antidote
Protamine Sulfate
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2 mins
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
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2 mins
Iron Antidote
Antidote
DeFEroxamine
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22 secs
Lead Antidotes
Antidotes
Penicillamine
Dimercaprol
CaEDTA
Succimer
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58 secs
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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1 min
Opioids Overview
Indications
Pain
Weaning
Cough
Diarrhea
Mechanism of Action
Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
Decrease Synaptic Transmission
Side Effects
Respiratory Depression
Addiction
Miosis
Constipation
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2 mins
Opioid Antidote
Antidote
Naloxone
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28 secs
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
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1 min
Tricyclic Antidepressants (TCAs) Overview
Mechanism of Action
Blocks Serotonin and NE Reuptake
Lipid-soluble
Side Effects
Adverse CNS Effects
Anticholinergic
Antihistamine
Tri-C: Convulsion, Coma, Cardiotoxicity
Blocks Alpha1 Receptors
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2 mins
Tricyclic Antidepressant (TCA) Antidote
Antidote
Sodium Bicarbonate (NaHCO3)
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26 secs
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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58 secs
Vancomycin Side Effects & Toxicity
Side Effects
Thrombophlebitis
Nephrotoxicity
Ototoxicity
Diffuse Flushing Called Red Man Syndrome
Prevent with Antihistamine
Prevent with Slow Infusion
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2 mins
Dilated Cardiomyopathy
Chronic Alcohol Abuse
Doxorubicin Toxicity
Cocaine Use
Wet Beriberi
Hemochromatosis
Coxsackie B
Chagas Disease
Peripartum
S3
Eccentric Hypertrophy
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2 mins
Torsades de Pointes
Characteristics
Polymorphic Ventricular Tachycardia
Prolonged QT Interval
QRS Twist Around Isoelectric Line
Causes
Congenital
Antibiotics
Antiarrhythmics
Antipsychotics
Antidepressants
Electrolyte Deficiencies
Complications
Ventricular Fibrillation
Treatment
Stable: Magnesium Sulfate
Unstable: Defibrillation
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3 mins
Amphetamines Intoxication Assessment
Euphoria
Insomnia
Mydriasis
Diaphoresis
Hypertension
Tachycardia
Paranoia
Anxiety
Anorexia
Seizures
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2 mins
Amphetamine Antidote
Antidote
Ammonium Chloride (NH4Cl)
Acidify Urine
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34 secs
Sumatriptan
Mechanism of Action
Short Half-Life
5-HT Agonist
Inhibits Trigeminal Nerve Activation
Induces Vasoconstriction
Indications
Migraine
Cluster Headache
Side Effects
Increased Risk of Serotonin Syndrome
Paresthesias
Coronary Vasospasm
Contraindication
Prinzmetal's Angina
Coronary Artery Disease (CAD)
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3 mins
Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)
Mechanism
Smooth Muscle Contraction
Vasoconstriction
Indications
Migraine
Postpartum Hemorrhage
Side Effects
Nausea and Vomiting
Severe Hypertension
Tachycardia
Considerations
2nd Line Agent
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2 mins

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