6 Flashcards
strongest risk factor for PID
multiple sexual partners
wide insignificant confidence interval due to
small sample size
case fatality rate
no. of people who die from specific condition
single rubbery mobile breast mass in young woman
tender solitary mass
fibroadenoma
breast cyst
Normal breasts +no hair+ no menses
diagnosis
androgen insensitivity syndrome
testes, no uterus, 46 XY, adult male levels of testosterone
RR
OR
risk of developing disease->observational
exposure and outcome
asymmetry in funnel plot
publication bias
Preggo exercise
no scuba diving or contact sports
Clozapine side effect
neutropenia, monitor ANC
used for refractory schizophrenia
Infantile pyloric stenosis imaging
Associated with abx
ultrasound
erythromycin, azithromycin (post exposure prophylaxis for pertussis)
Preggo TB treatment
no pyrazinamide
cat scratch disease treatment
azithromycin
chronic bacterial prostatitis
treatment
recurrent UTI symptoms, pain during ejaculation, GU pain for >3 months
6 weeks of Bactrim/Cipro
Diabetes diagnosis
symptomatic: HgbA1c> 6.5%, fasting glucose >126, glucose >200 after tolerance test ONCE
asymptomatic: must repeat
Hashimoto’s thyroiditis with rapid enlargement of thyroid
thyroid lymphoma
in skewed distributions what is the most valid measure of central tendency
median
quality adjusted life years vs disability adjusted life years
every yr of this life to blank year of full health vs
years of life lost and years lived with disability
Reticular rash with arthritis
parvovirus, ff URI
slapped cheek malar rash
Tourette is associated with ADHD and OCD.
treatment
antipsychotics, therapy
persistent hematuria with peripheral eosinophilia
diagnosis
treatment
schistosomiasis
urine sediment microscopy
praziquantel
surgical correction of spine
convexity>60
Apnea of prematurity vs periodic breathing
> 20s, resolves by 37 weeks vs 5-10s pauses and rapid breathing, resolves by 6 mos
IVC filter complications
recurrent DVT, IVC thrombosis
pressure ulcer
moist wound environment
debride devitalized tissue
paget disease of the bone
incidental, elevated alk phos, normal calcium
bone scan and bisphosphonate
Acute intermittent porphyria
elevated urinary porphobilinogen
acute psychosis, abdominal pain, family history
Congenital adrenal hyperplasia
treatment
21 hydroxylase deficiency: no cortisol/aldosterone, elevated 17 hydroxyprogesterone
ambiguous genitalia, hyponatremia, hyperkalemia, hypoglycemia, hypotensive shock
glucocorticoid, mineralocorticoid (hydrocortisone+fludrocortisone)
Meds that cause SIADH
SSRIs, carbamazepine, valproic acid
knee dashboard injury
posterior cruciate ligament
kappa statistic
inter-rater reliability
First degree relative with colon cancer or adenomatous polyps <60 yo or 2 at any age
screen at 40 yo
chronic cough in children
spirometry to test for asthma, CXR
abnormal puberty evaluation
measure hormones first-FSH, testosterone, LH
increased prolactin and TSH decrease GnRH
Parkinson diagnosis
treatment
bradykinesia (resistance to flexion) + ridigity/ tremor
pramipexole, levodopa+ entacapone later
speech development at 2 yo
> 50 words with 2 word phrases
Infected obstructing kidney stone
perc nephrostomy or ureteral stent placement
down’s syndrome heart
higher risk of
endocardial cushion defect
acute leukemia, Alzheimer, autism, ADHD, depression, seizures
FOOSH with decreased grip strength, ROM, tender anatomic snuffbox
complications
scaphoid fracture
if initial imaging negative, splint wrist and reimage in a week
if nondisplaced->cast, otherwise ortho
avascular necrosis and nonunion
abnormal sperm analysis
intrauterine insemination/ IVF
v fib/VT
PEA/ asystole
shock
do not shock (CPR and vasopressors)
metastatic cancer biopsy
metastatic site first (lymph nodes)
Human bites org
eikenella corrodens
*consider tetanus
central venous sinus thrombosis
gradually worsening headache, max in morning, increases with Valsalva
neuro symptoms 2/2 venous congestion
in spite of hemorrhage, treat with heparin
pericardial calcifications in CXR
constrictive pericarditis
common complication of CABG
CHF or COPD exacerbation pre op
treat and delay surgery
*stop smoking 4 weeks before
Refractory celiac
dietary review, endoscopy
shared headache, nausea, malaise, dizziness (flu-like)
diagnosis
treatment
CO poisoning
ABG with carboxyhemoglobin
high flow oxygen through nonrebreather
RSV bronchiolitis complication
recurrent wheezing, avoid triggers of airway reactivity
carotid artery stenosis <70% or 100%
medical management
no CEA
aspirin, statin
sun protection
SPF 15 for everyday use
SPF 30 for outdoor work/recreation
15-30 mins before, reapply q2hours
varenicline, buproprion CI
psych, seizures
invasive squamous cell skin cancer management
surgery, cryotherapy, electrosurgery, radiation (in older patients who refuse surgery)
Sydenham chorea
treatment
manifestation of acute rheumatic fever
emotional lability, irregular rapid jerking movements, facial grimacing, decreased strength, pronator drift
penicillin till adulthood, resolves
Grief vs MDD
Thoughts of suicide revolve around dead person not hopelessness/worthlessness
seborrheic dermatitis (dandruff) retreatment
weekly to prevent recurrence
Clozapine side effect
neutropenia, monitor ANC
pulm fibrosis on CXR and PPD
latent
fibrosis not active TB
fetal growth restriction with reversed/absent end-diastolic flow
deliver
DKA glucose on insulin drip
when to stop insulin drip
how to
Glucose <200 + anion gap= halve insulin rate, add dextrose to fluids
gap<12, glucose <200, bicarb>15, patient able to eat
start subq insulin, continue drip for 1-2 hours
Febrile hemolytic reaction after transfusion
fever, flank pain, hematuria, DIC
stop and aggressively hydrate
ABO mismatch
ocular melanoma management
diagnosis
treatment
asymptomatic, <10mm by 3mm->close f/u
ultrasound
radiotherapy
SAAG < 1.1
cancer, TB, renal, pancreatitis, serositis
Pancreatitis diagnosis
2 of the ff: characteristic pain/ amylase or lipase/imaging
labs, no imaging needed
necrotizing fasc organism
treatment
GAS
blisters, severely tender, fever, hypotension, shock
urgent surgical debridement and abx (vanc+ clinda (for toxins)+zosyn/meropenem)
positive stress test with high risk features
ST depression at low workload, ST elevation, ventricular arrhythmia-> CATH
positive stress test->aspirin, statin, beta blocker
Primary CNS lymphoma in HIV prognostic factor (EBV)
treatment
CD4 count
radiation, steroids
Adenomyosis treatment
progestins->hysterectomy
Nonfunctioning pituitary adenomas usually from
treatment
prolactin-secreting adenomas
GnRH cells, alpha subunit increased, FSH and LH decreased
transphenoidal surgery
cabergoline
nonfunctioning pit adenomas may block pit stalk and hypothalamic inhibition of prolactin secretion
Isoniazid + pyridoxine
to prevent neurotoxicity
pyrazinamide-hyperuricemia
OCP CI
migraines with aura, BP > 160/100, >35yo who smoke >15 cigarettes/ day
Rapidly spreading erythema with well-demarcated raised borders, tender, tense
treatment
erisypelas-strep pyogenes (GAS)
penicillin
abscess is fluctuant
Skin colored small papules with indented centers
molluscum contagiosum-skin to skin contact
HIV testing
Legg-Calve-Perthes
AVN of hip, deformity of femoral head
Neonatal clavicular fracture
supportive care
x ray only
pin arm to chest
Graves vs postpartum thyroiditis vs silent thyroiditis
hyperthyroidism
high uptake vs low uptake
Preggo TB treatment
no pyrazinamide
bisphosphonate FRAX
> 20% osteoporotic fracture, >3% hip
Flu vaccine CI
no live for anyone, just IM inactivated
mild allergy to eggs-get it
severe allergy to eggs-get it in health setting
severe allergy to vaccine itself-only CI
Croup
RSV
parainfluenza, barking cough, hoarseness, stridor
nasal congestion, rhinorrhea, apnea
use of herbal supplements
document
acute chest syndrome
treatment
new pulm infiltrate on CXR, fever, hypoxemia, chest pain, tachypnea
cephalosporin, macrolide, pain control, IV fluids
Antidepressant trial
6 weeks if effective but intolerable->switch within class if ineffective->switch class
Atopic dermatitis of the face
topical tacrolimus
Colonoscopy polyps
> 2 cm/carcinoma in situ: 2-6 months
Familial polyps: annual
otherwise 3 years
Amiodarone thyroid
impairs T4->T3: self-resolves
thyroiditis with thyrotoxicosis: steroids
hypothyroidism: levothyroxine only
Psychosis
rule out substances and medical causes first
Delirium pharm vs physical restraints
Haldol first.
hyperaldosterone
hypertension, hypokalemia->polyuria
epistaxis
nasal pinching->topical vasoconstrictor for max of 3 days
pseudohypoparathyroidism
hypocalcemia symptoms
end-organ resistance to pth
seizures, muscle cramping, calcifications, hyperreflexia, cataracts
*pth decreases phosphorus by renal excretion and increases calcium
gout htn
ACEI/ARB (losartan)
brain death reflexes
central should be gone, peripheral may be present
Increased risk for spontaneous abortion
prior, advanced maternal age, extreme BMIs, substance abuse
SIADH treatment
water restrict
Hip OA in young adults and adolescents
Abnormal acetabular development
shallow hip socket with inadequate support of femoral head->accelerated wearing of cartilage
eosinophilia in diarrhea
treatment
parasites
pulm->GI symptoms
albendazole
Ecthyma gangrenosum
management
immunocompromised, pseudomonas bacteremia
rapid evolution of lesion->erythematous macule->papule->bullae->painless, gangrenous ulcer
blood, wound cultures, two medications sensitive to pseudomonas
*painful, neutrophilic->pyoderma gangrenosum
Secondary hypertension in children, young adults
in older adults
renal parenchymal disease (nephrotic syndrome)
hyperaldosteronism, renal artery stenosis
focal, glistening, white, mound-like lesions that extend into vitreous, painful eye, decreased visual acuity in patient on TPN
treatment
invasive candida (endophthalmitis)
systemic antifungal (amphotericin B), intra eye injection, vitrectomy
Post chole diarrhea
excess bile salts
bind with cholestyramine
also seen with ileal resection/short bowel syndrome
levothyroxine + OCPs
increased TBG->decreased thyroid hormone->increase dose
steroids and androgens cause the opposite
