7 Flashcards
(33 cards)
lichen planus diagnostic test
(intense pruritic polygonal shaped violaceous papules in flexure surfaces (mostly wrist), buccal mucosa, or external genitalia)
punch biopsy
Treatment of polycystic ovarian disease
weight loss
if that fails, then clomiphene citrate
In absence of MPOA or advance directives, who should the staff contact?
highest priority surrogate decision maker
ethics committee only consulted when opinions are opposing
Horner’s syndrome (miosis, ptosis and often anhidrosis) and unilateral headache, ddx and best diagnostic test
carotid artery dissection
CT angiography is first step, catheter angiography is gold standard, MRA alternative
Whats the best initial screening test for thyrotoxicosis for pregnant ladies?
TSH
total T4 and T3/free T4 T3 not as reliable as they are higher than normal, has to be adjusted
When is amiodarone preferred as antiarrythmic drug in paroxysmal afib patients?
structural heart disease (LVH, CHF)
normal heart: flecainide
Diagnosis and treatment for epistaxis, petechiae, worse with use of aspirin, normal platelet count.
VWF
- ristocetin cofactor assay, VWF level (carries factor VIII in blood)
- first line tx: desmopressin/DDAVP
- next best step: factor VIII replacement (has both vwf and factor VIII)
Drugs that increase TBG and decrease free T4 may need higher doses of thyroxine replacement. Which drugs?
estrogen
tamoxifen
raloxifene
methadone, heroine
Drugs that decrease TBG and increase free T4 may need lesser doses of thyroxine replacement. Which drugs?
steroids
androgens
danazol
hydrothorax, a common cause of transudative pleural effusion in patients with cirrhosis and ascites and is located on the right. Treatment?
- sodium restriction, diuretics
- TIPS as second line
E.coli and GBS are common bugs in neonates (<28 days), strep pneumo and neisseria (>28 days). Broad spectrum abx needed immediately. Which ones?
- ampicillin and gentamicin or cefotaxime
- ceftriaxone or cefotaxime, +/- vanc based on meningeal involvement
Infant botulism from environmental dust containing spores. Treatment?
Human derived botulinum toxin
Following viral pericarditis/cardiac surgery, pt presents with right heart failure, peripheral edema, ascites, elevated JVP, hepatojugular reflex, Kussmaul’s sign, pericardial knock, pericardial calcifications on chest radiograph. Ddx?
Constrictive pericarditis
Saw palmetto’s use and SE
benign prostate hyperplasia
risk of bleeding
Most common complication of lumbar myelomeningocele
bladder dysfunction
Which smoking cessation meds should be avoided in pts with depression or SI? seizures?
avoid varenicline for unstable psych sx
avoid buproprion for seizures
abrupt onset of butterfly rash, sharp demarcation, painful, red, edematous. ddx? common bug?
erysipelas
group a strep
postpartum endometritis treatment?
clindamycin and gentamicin
* metronidazole is contraindicated in breastfeeding mothers
maculopapular rash that spreads from face caudally, acute arthritis, thrombocytopenia, and encephalitis, fever, lymphadenopathy of posterior cervical and suboccipital nodes. Ddx?
Rubella
Cough, conjunctivitis, coryza, blue white koplik spots, starts on face and spreads caudally. Ddx?
Measles/ Rubeola
Causes of post operative hypoxemia
immediate: airway obstruction/edema, residual meds effect
early: bronchospasm (wheezing)
1-5 days: pneumonia
2-5 days: atelectasis
3 days to over a week: PE
Which electrolyte imbalance post op causes hyperactive deep tendon reflexes
hypocalcemia
Management and treatment of seborrheic keratosis
if symptomatic and cosmetically disfiguring, then can do curettage/shave excision
otherwise, no treatment needed
Whats the best contraceptive method for pts with sickle cell disease?
progestin only methods (intrauterine device), as it decreases amount of menses
estrogen containing methods promote thromboembolism
copper IUD has severe bleeding and dysmenorrhea first year
