2 Flashcards
analgesic nephropathy
florid nephrotic range proteinuria
multiple myeloma protein usually not on u/a-UPEP
Subclinical hypothyroidism
Treat if
complications
Elevated TSH, normal free T4, get anti-TPO
TSH >10, symptomatic, pregnant, infertile, goiter, positive antibody
miscarriage, preeclampsia, preterm birth, pregnancy complications
severe bradycardia 2/2 RCA MI
IV atropine
Refeeding CHF
hypophosphatemia-oral phosphate (no diuretics)
also watch mg, k, thiamine
Sickle cell
aplastic crisis
hyperhemolytic crisis
dactylitis, hemolytic anemia. HgbS on electrophoresis
transient cessation of erythropoiesis due to parvovirus, low rec count, transfuse
increased rec count
Disseminated VZV
IV acyclovir (ganciclovir for local), airborne and contact precautions
Helminth infection
eosinophilia, chronic diarrhea, high risk of reinfection, treat entire family
Pseudotumor cerebri vs migraines
If fat and fertile, do eye exam
migraines can be associated with aura-vision changes, nausea, tingling
friable cervical lesion
rule out cancer
Hot flashes treatment
escitalopram/venlafaxine
Neonates with bilirubin >20
breastfeeding jaundice
exchange transfusion
supplement with formula
Hawthorne effect
change in behavior due to observation
GBS babies
observe for 2 days
if no abx >4 hours before delivery AND preterm or PROM, obtain CBC and culture
post op SIADH hyponatremia
mild-fluid restrict, salt tabs
only symptomatic, severe with seizures-hypertonic saline
Suppurative otitis media
copious drainage, feeling better after tympanic membrane ruptures
Diaper dermatitis
No powder-aspiration risk
tx: zinc oxide, petrolatum
* candida dermatitis-nystatin, miconazole
synthroid drug interactions
calcium and iron should be taken 3-4 hours later
45 XO
Turner syndrome: get TTE (cardiac defects), renal ultrasound, TSH, hearing and vision tests
Testicular cancer workup
ultrasound, CT scan, CXR, serum markers, orchiectomy
Indolent pna with interstitial infiltrates in immunocompromised patient
tx
steroids if
pcp
bactrim
o2gradient >35 or pao2 <70 (inflammation from pcp lysis)
if sputum culture is negative->bronchoalveolar lavage
Digoxin toxicity
induced by
N/V, anorexia, fatigue, confusion, cardiac abnormalities, visual disturbances
verapamil, amio, quinidine
burning sensation, mucoid discharge that crusts eyes shut,
infectivity
w/ itching
viral
over after discharge resolves bacterial-after 24 hr of topical therapy
allergic
TSH in history of thyroid cancer
Use levo to suppress TSH to low normal range
CAP treatment
Mac/doxy (healthy), mac+beta lactam/fluoroquinolone (comorbidities)
Inpt: fluoroquinolone OR beta lactam+mac
ICU: beta lactam+ mac OR beta lactam+ fluoroquinolone
TP FP PPV (TP/ TP+FP)
FN TN NPV (TN/TN+FN)
Sens Spec
(TP/TP+FN) (TN/TN +FP)
Spec, sens table
tuberous sclerosis testing
cause of death
Imaging, EEG, skin exam (ash-leaf, hypopigmented), benign tumors
epilepsy (neurologic impairment), aspiration pna, obstructive hydrocephalus
Lead time bias vs length time bias
Screening catches earlier vs patients who are screened have slowly progressive form of disease
Asthma exacerbation do not need imaging
prednisone and albuterol
myxedema coma
pretibial myxedema
hypothyroidism
synthroid increases risk of MI in CAD, start slowly
iodine loading is for hyperthyroidism
Grave’s-hyperthyroidism
Essential tremor vs Parkinson’s
essential tx
movement, no bradykinesia, no rigidity vs resting tremor
propranolol if necessary
Acute hep c
antibody may be negative, get viral load
clozapine risk
agranulocytosis
EBV mono treatment
complication
Supportive care and NSAID
aplastic anemia, airway obstruction-steroids
otitis externa
mild-topical acetic acid
moderate-topical abx
severe with edema-placement of a wick
uterine atony
postpartum hemorrhage-> massage uterus+ oxytocin/misoprostol/methylergonovine/carboprost
tetanus ppx for bite wounds
dirty: booster if last dose >5 years ago, vaccine and ig if unimmunized/not fully immunized
clean: vaccine if last dose >10 years ago, vaccine if unimmunized
lupus nephritis
monitoring
GET BIOPSY!
anti-dsdna and complement (will be low) levels
Postconcussive syndrome
headache, confusion, amnesia, difficulty concentrating, vertigo, mood disorder
Pseudomonas pneumonia (HAP or structural lung disease)
gentamicin/zosyn/Levaquin (2 of 3 required)
if respiratory failure-vanc to cover for MRSA