Custom deck 1 Flashcards
________ may be considered in patients who are not responding to first-line treatment for schizophrenia or who are continually engaging in self-harm or suicidal behavior. Patients receiving ________ are entered into a national registry and white blood cell monitoring for agranulocytosis must occur at specific intervals. While agranulocytosis is rare (approximately 0.8% of patients), it is life-threatening and therefore requires stringent monitoring. Other side effects of _______ can include seizures, myocarditis, weight gain and sedation.
Clozapine
What is the treatment for a patient with only two copies of the alpha-globin chain?
Patients with alpha-thalassemia trait typically do not require treatment. They are often misdiagnosed as being iron deficient and for this reason should be identified as having alpha thalassemia to avoid unnecessary iron treatment. Four copies of the alpha-globin chain are present in healthy adults. When three copies are present, the patient is said to be a silent carrier of alpha-thalassemia. When two copies are present the patient has alpha thalassemia trait which is a minor form of thalassemia. When only one of globin chain is present, the patient has Hemoglobin H disease. These patients can undergo hemolytic crisis during periods of stress or infection. Lab findings will show a mild anemia with an extremely low mean corpuscular volume (MCV). Microcytes, hypochromia, target cells, and acanthocytes can be found on the peripheral blood smear. Hemoglobin electrophoresis and reticulocyte counts will be normal.
________ are approved and generally effective for managing chronic urticaria.
Nortriptyline, as well as most other tricyclic antidepressants.
First-line treatment in a patient with an autosomal dominant bleeding disorder where mucosal bleeding is characteristic, such as seen in epistaxis, gingival bleeding, menorrhagia, and GI bleeding.
Desmopressin (DDAVP) is the first-line treatment for bleeding and is sufficient in most patients. von Willibrand’s factor is low or absent. vWF facilitates platelet adhesion and links platelet membrane receptors to the endothelium.
What is the treatment for a patient with a reciprocal translocation between the long arms of chromosomes 9 and 22. This is a myeloproliferative disorder that occurs most often in middle-aged patients, causing fatigue, night sweats, and low-grade fevers. The physical exam may show splenomegaly and sternal tenderness as marrow overexpansion progresses. Laboratory findings include a median white blood count of 150,000 and peripheral blood showing a left-shifted myeloid series. The red blood cell morphology is normal, and platelets may be normal or slightly elevated. The bone marrow is hypercellular with marrow cells showing less than 5% myeloblasts.
The initial treatment of choice for chronic-phase CML is imatinib mesylate (Gleevec®) , a tyrosine kinase inhibitor that is able to normalize hematologic abnormalities and suppress the abnormal Philadelphia chromosome gene in 98 percent of cases. Untreated CML is an unstable disease that can progress to an accelerated blast crisis similar to acute leukemia. An allogeneic stem cell transplant may be needed if medical therapies cannot control the disease, or if the patient has accelerated to a blast crisis.
Treatment for a child with poor feeding, decreased suckling, loss of facial expression, constipation, and noticeable neck and peripheral weakness. It occurs in children younger than 12 months of age, with a peak incidence at 3 months. It has been associated with the ingestion of corn syrup, and vacuum or environmental dust.
Supportive care, respiratory monitoring. Equine heptavalent botulinum antitoxin (Age > 1 year). Human derived botulism immunoglobin (Age < 1 year). Contact CDC.
What is the treatment for a toddler or school-age children with prodrome of fever, malaise, sore throat, and anorexia over a couple of days, followed by the appearance of the characteristic rash. Transmission is by the fecal–oral route and usually occurs in the summer and fall months in crowded places where children congregate such as a swimming pool.
Treatment is supportive with oral fluids and antipyretics. In most cases, the course is self-limited, resolving in 7–10 days. Herpangina is a characteristic enanthem produced by several enteroviruses, with coxsackie A, B, and echovirus being the most common. This condition is characterized by oral lesions that usually appear in the posterior aspect of the mouth, specifically on the anterior tonsillar pillars (most common), posterior pharyngeal wall, soft palate, tonsils, uvula, and occasionally the posterior buccal mucosa.
Used for four months has been shown to be as effective as isoniazid in treating latent TB but is less hepatotoxic. It is not recommended for those with HIV/AIDs, or women who are pregnant or may become pregnant during the four-month course of treatment.
Rifampin
Treatment for a patient with a recent hx of a camping trip and the abrupt onset of fever, headache, myalgias and shaking chills. Vomiting and diarrhea occur less frequently and up to 1/3 of patients develop a rash. Leukopenia, thrombocytopenia, and elevated liver enzymes occur in 50 to 90% of patients.
This patient likely has Erlicheosisand Doxycycline is the antibiotic of choice and curative when administered for 7 to 14 days. Rifampin is an acceptable alternative.
What is the treatment for Chlamydia?
Azithromycin 1 gram x 1 or doxycycline 100 mg 1 tablet twice daily for 1 week.
What is the USPFT guideline for cervical cancer and HPV?
Don’t screen if under 21 regardless of sexual hx.
_________ hemorrhage results in a rapid progression of hemiplegia, nausea, vomiting and headache over 30 minutes, which is quickly followed by ipsilateral deviation of the eyes, stupor, coma and mydriatic pupils (“blown-pupil”, associated with brainstem compression and oculomotor nerve palsy).
Putamen hemorrhage. Will have contralateral hemiparesis, contralateral sensor loss, aphasia, neglect, apraxia.
_________ hemorrhages are characterized by total paralysis, rapid coma, decerebrate rigidity (abnormal posturing marked by shoulder adduction, elbow extension, wrist pronation and flexion, digit flexion, leg extension and plantarflexion) and small (miotic), not mydriatic, reactive pupils.
Pontine hemorrhages
Why would you recommend NSAIDs over acetaminophen for dysmenorrhea?
Recommending acetaminophen will not be as beneficial as ibuprofen since it does not directly affect the prostaglandins responsible for primary dysmenorrhea.
Patient will have a cumulative blood loss of ≥1000 ml or bleeding associated with signs and symptoms of hypovolemia within 24 hours of birth regardless of route of delivery
PE will show an enlarged “boggy” uterus
Most commonly caused by uterine atony
Treatment is uterine massage, oxytocin, prostaglandins, or surgery
Postpartum hemorrhage
