01-04 Flashcards
Reduced efficacy to ECT seen in?
Prolonged episode
Lack of response to meds
Co-existing psych disorder
Absolute ECT contraindications
None
Hard to control hypertension and hypokalemia workup
Plasma renin/aldosterone ratio to look for primary hyperaldosteronism
What should be suspected in any child with fever, cyanosis, and respiratory findings
Pneumonia
Reasons to admit a child with pneumonia
- toxic appearance
- hypoxemia
- signs of respiratory distress
- dehydration
When do you introduce solid foods to children
4-6 months
extrusion reflex present until 4 months
Ultrasonic pulse therapy doesn’t help what kind of fractures
Stress fractures
Best test for late onset hypogonadism
Total T (free T is too expensive) *FSH and LH levels will help determine primary vs secondary*
Low TSH in a patient receiving levothyroxin indicates
Overreplacement
Typical plantar fasciitis features
point tenderness to palpation on the plantar surface of the heel at the medial calcaneal tuberosity where the calcaneal aponeurosis inserts
When is an X-ray necessary for suspected plantar fasciitis
When there is a hx of trauma or the diagnosis is unclear
Best physical exam test for ACL tear
Lachman test
What is McMurrey’s test used for
to detect meniscal tears
MGUS to myeloma detected when
When there is an increase in organ damage
Numbness and weakness over the anterior thigh
Femoral neuropathy
What is Meralgia paresthetica
numbness and paresthesia over the anterolateral thigh with no motor dysfunction
Iliofemoral atherosclerosis produces
Intermittent claudication involving one or both calf muscles but would not produce the motor weakness noted in this patient
Low dose estrogen contraceptives reduce risk of what cancers
Ovary, endometrial, and colorectal
Two main painful places with PMR
pain and stiffness in the shoulder and pelvic girdle
dramatic response to corticosteroids
What is refeeding syndrome
Shifts in fluids and electrolytes that follow, hallmark is hypophosphatemia
Signs of hypophosphatemia
nausea, vomiting, hypotension and delirium
Two things that decrease risk of oral candidiasis when using inhaled steroids
Using a valved holding chamber and rinsing mouth after use
What do you do in an older person or teacher with hoarseness that does not improve for 3 months
Laryngoscopy –> Then voice therapy if all other issues ruled out
Metabolite of oxazepam
Diazepam
Is morphine a product of methadone?
No
Big 4 of mono
sore throat, fatigue, myalgias, and lymphadenopathy
When should steroids be used in mono
Only when there is airway compromise
Initial therapy of hypercalcemia of malignancy
Fluid replacement with normal saline (enhances renal excretion of calcium)
Pamidronate only when patient is back to euvolemia
In symptomatic uterine fibroid patients, when is myomectomy recommended over fibroid embolization
When the patient wishes to become pregnant in the future
Fibroid embolization shorter time off work and less recovery
What causes melanosis coli
abuse of anthraquinone laxatives such as cascara, senna, or aloe
Valsava increases the intensity of what murmer
HOCM
Most common hip disorder in the young
Slipped capital femoral epiphysis (more common in boys and overweight children)
limping, leg pain, and limited internal rotation
PEG tubes in elderly don’t do anything but
Increase use of restraints
no increase in quality of nutrition
Best test for COPD diagnosis
spirometry
Pain with eye movement suggests? Next step
An orbital problem
Imaging studies if you suspect an orbital problem
When should a high risk patient get a colonoscopy
At 40 or 10 years before the earliest age a family member was affected, then every 5 years if normal
Drugs that cause drug induced lupus pleurisy
hydralazine, procainamide, and quinidine
When is doxy contraindicated in pregnancy
2nd and 3rd trimesters due to risk of tooth staining
Effect of an extra 100 calories a day
weight gain of approximately 5 kg, which will then be maintained (fat must be fed, so newly created tissue will need increased calories to be fed)
What controls asthma the best as a single agent
Inhaled corticosteroids
What is infliximab
TNF-a inhibitor
What should be stopped before getting a CT contrast
Metformin
