6 Flashcards
what disease are you looking for with TPO antibodies
Hashimoto thyroiditis
hyperglycemia, ketoacidosis in setting of fever, sepsis, dehydration, hypotension
stress hyperglycemia- transient elevated glucose in setting of illness (not DM!)
physiological lung mechanism of COPD and emphysema
VQ mismatch!
COPD- low vent: perfusion
emphysema: high vent: perfusion
what type of shoulder pain affected (anterior, post, lateral) for rotator cuff tendinitis affecting abduction and ext rotation
lateral shoulder pain
which bug illness? fever + severe polyarthralgias
chikugunya
managing hep B
70% asymptomatic, few get badly sick. only hospitalize badly sick otherwise treat as close OP.
Hep B vaccine/Ig isnt helpful for known virus. And antiretrovirals only used for acute liver failure or immunocompromised
risk of turning from acute to chronic hep B depending on the age group
adults: <5%
age 1-5: 20-50%
perinatal: 90%
what AED changes can you make after conception in pregnant woman with epilepsy?
no changes!
can you use AEDs in breastfeeding?
yes
meds preferred for maintenance of afib with heart failure
amiodarone
dofetilide
can you use rate control meds after cardio version for afib?
no not helpful (they failed rate control)
rhythm control for afib with no CAD or structural heart disease
flecainamide,
propfenone
ovarian torsion dx
US with doppler
maintenance on SSRI for one episode vs >1
1: 6 months
> 1: 1-3 years or indefinitely
which back pain improves with leaning forward and sitting and worse with extension?
lumbar spinal stenosis
dx for spinal stenosis
MRI
stress test- exercise or pharm indications
exercise preferred but do pharm when they cant tolerate exertional walking
patient with high Ca, high Phos, high PTH
tertiary hyperparathyroidism
how does CKD affect PTH
secondary hyperparathyroidism-
low vitamin d, phosphate retention –> low serum Ca –> PTH synthesis
——> then nl calcium levels
treatment for tertiary hyperparathyroidism
parathyroidectomy if:
- persistent hypercalcemia, hyperphos
- very high PTH level
- soft tissue calcification
- intractable bone pain
treatment of choice for sclereoderma renal crisis
ACEI
fully immunized patients get a bad animal bite. get tetanus shot/ig?
get tetanus booster if:
clean wound and last vaccine >10 years
dirty wound and last vaccine >5 years
non-immunized patients get a dirty animal bite. what do they get tetanus wise?
tetanus booster and Ig
fever, ear pain, crankiness, purulent ear drainage
supporative otitis media
when to avoid exercise in pregnant patient:
cervical insufficiency, cerclage
PPROM
placenta previa
persistent vaginal bleeding in 2nd and 3rd tri
Underlying conditions (HTN, lung dz, anemia)
osteoporosis vs osteopenia t scores
penia:
treatment for acute cystitis or asx bacteriruia in pregnant woman
cephalexin
amox-clauv
fosftomycin
nitrofurantoin- not in 1st semester
bilateral hilar adnopathy, joint pain, cough, hypercalcemia
sarcoid
prognosis of sarcoid
most (75%) resolve over time
