Form 1 Block 1 - Created July 18 Flashcards
depression versus grief
both: sad, anhedonia, sleep and appetite change, impaired concentration
grief: sadness less persistent, no low self-esteem, no excess in guilt, no SI
what to do with kid who swallowed a coin
do endoscopy if UNKNOWN time of ingestion, > 24 hrs, or having SYMPTOMS
when to operate on AAA
having sxs, size >2x normal aorta, size >5.5cm, growth >0.5 cm over 6 months
when to do parathyroidectomy
age <50, symptomatic hyperCa, osteoporosis, kidney stones, CKD, U Ca excretion >400 mg/day
what to do with high PTH patient if parathyroidectomy not indicated
follow-up with serum Ca, Cr, and DXA testing
high-intensity statins
atorva 40-80 mg
rosuva 20-40 mg
when to give high-intensity statins
- all patients < 75 with established ASCVD
- LDL >190
- age>40 w/ DM and 10 yr risk >20%
- high 10yr risk otherwise
description of erythema multiforme and leading cause of it
erythematous plaques with central clearing that begin on limbs; HSV
what to do in pt with breast mass and > 30 yo
do diagnostic mamm first
a) when it’s benign or indeterminate, do U/S next to characterize the mass
b) if malignant, do core needle biopsy
what to do in pt with breast mass and < 30 yo
do U/S first
a) simple cyst - needle
b) can’t tell - mamm
c) complex cyst/mass - biopsy
presentation of PE
SOB, pleuritic CP, sinus tachycardia, hypoxemia
CT appearance of pulmonary infarct (possible complication of acute PE)
hemispherical consolidation abutting the pleura (look for wedge-like appearance)
bleomycin pulmonary fibrosis on CT
diffuse pattern of reticular septal thickening and honeycombing
cells from which HCC arises; tumor marker
liver parenchyma; AFP
who can “request” organ donation from a family
Organ Procurement Organization staff member or a physician who has undergone specialized training
prostate cancer: very low-risk
- Gleason score of 6 or less with < 3 cores affected
- normal DRE
- PSA < 10
prostate cancer surveillance in very low-risk individuals
- PSA q3-6 mo.
- DRE qYr
- repeat prostate biopsy in 1 yr
presentation of inhalant use
transient euphoria, lethargy, poor coordination, LOC, may look drunk; lasts 15-45 minutes
presentation of cocaine use
tachycardia, HTN, euphoria, hyperarousal
presentation of pertussis
1st: 1-2 wks URI sxs
2nd: 2-6 wks of cough w/ insp. whoop, posttussive V, apnea
dx and tx of pertussis
dx: Cx or PCR; lymphocytic leukocytosis
tx: macrolides to pt and close contacts
presentation of sarcoidsosis
Afr.Am., gradual onset of SOB, cough, malaise, wt loss; imaging shows ILD (opacities, nodules, cysts, fibrosis) and hilar LAP
confirmation of dx
noncaseating granulomas on transbronchial biopsy
silicosis CXR
multiple, bilateral, small/round nodules in upper lobes
when to do surgery for kids with inguinal hernia
Asx: 1-2 wks
Incarceration: immediate
when to do surgery for hydrocele; varicocele; undescended testis
hydro: resolves by age 1
varico: early puberty
testis: 6 months
orthostatic hypotension
> 20 mmHg drop in SBP or >10 mmHg drop in DBP
contraindications to menopausal hormone therapy
coronary heart dz, active liver dz, h/o breast cancer, venous thromboembolism, or stroke
possible meds that can interact with statins and cause statin-induced myopathy
cyclosporine, HIV protease inhibitors, gemfibrozil, macrolides
timing of pneumococcal vaccines in adults
PPSV23 - <65 with severe dz and again at age 65
PCV13 - at age 65 if pt didn’t get it before
Kawasaki criteria
Fever > 5 days plus 4 of CREAM: Conjunctivitis Rash Edema (hands/feet) Adenopathy (cervical) Mucositis
what to suspect with only prolonged aPTT, in setting of easy bruising
hemophilia A and B (XR, prior h/o of bleed), von Willebrand dz (prior h/o bleed), and certain acquired disorders (like coagulation factor inhibitor)
what to do if pt has new atrial flutter or fib for >48 hours
start anticoagulation and continue for 3/+ wks (warfarin, apixaban, rivaroxaban, dabigatran)
meds for rate and rhythm control of a.fib or flutter
rate: digoxin
rhythm: amiodarone
chemical cardioversion of a.fib or flutter
IV ibutilide
