hammer17 Flashcards
When are HPV vaccines given?
9-11 and through age 26 in women and 21 for men
What is the presentation of traumatic carotid injury?
Gradual inset hemiplegia, aphasia, neck pain and thunderclap headache
What is the management of infectious mononucleosis?
Avoid contact sports for >3 weeks due to risk of splenic rupture
What is the treatment for bipolar disorder in patients not adequately controlled with monotherapy?
Lithium or valproate PLUS second generation antipsychotic
What is a characterstic feature of hydroceles and when do most hydroceles resolve? What do they incresae the risk for?
Transillumination. By 12 months of age. Inguinal hernia.
What is the cause of pain from a PE?
Occlusion of pulmonary artery by thrombus. Not distension of artery.
What are features of inflammatory cause of back pain?
Gradual onset, onset at age
What is the pathophysiology of hypertrophic cardiomyopathy?
Systolic anterior motion of the mitral valve leading to anterior motion of mitral valve leaflets toward interventricular septum. Contact berween mitral valve and thickened septum during systole leads to LVOT obstruction.
What is the treatment for uncomplicated cystitis?
Nitrofurantoin for 5 days, TMP/SMX, fosfomycin single dose. Urine cultire if first treatment fails.
What is the treatment for complicated cystitis and pyelonephritis?
fluoroquinolones
What murmur is heard in complete atrioventricular septal defect adn which childhood disorder?
Down syndrome. Loud S2. Systolic ejection murmur from increased flow across pulmonary vales from teh L to R shunt across ASD. Holosystolic VSD murmur.
What is Wallenberg syndrome? What causes it and what is presentation?
Lateral medullary infarct 2/2 PICA or vertrbral artery occlusion. Loss of pain and temperature over ipsilateral face and contralateral body, ipsilateral bulbar muscle weakness, vertigo, nystagmus, Horner’s syndrome. Motor function of the face and body is typically spared.
What should you suspect in Down patietns who present with UMN findings?
Atlantoaxial instability
What is the presentation of allergic contact dermatitis?
Primarily on exposed skin, erythema, papules, vesicles, chronic lichenification
What is the worst risk factor and most common risk factor for CAD?
Worst - DM. Most common is HTN.
How does sublingual nitroglycenrin have antiischemic effects in patients?
Systemic vasodilation, decrease in cardiac preload, decrease in LV systolic wall stress, decrease in afterload
What is the pathophysiology behing broken heart (tako-tsubo) cardiomyopathy? Treatment?
Massive discharge of catecholamines. Beta blockers and ACEi
What are risk factors for CAD? Correcting which factors provides the greatest immediate benefit?
DM, HTN, HLD, Cigarette smoking, Family history of premature CAD, Age above 45 in men and 55 in women. Smoking (50% decrease in 1 year adn 90% in 2 years)
What are the characteristics of ischemic pain?
Stable angina >2 to 10 to 30 min. Associated with SOB, nausea, diaphoresis, dizziness, lighheadedness, fatigue. Substernal, alleviated by rest. Radiates to neck, lower jaw and teeth, arms, shoulders
What is the best method of detecting ischemia without the use of EKG?
- Nuclear isotope uptake (thallium of sestamibi) 2. Echocardiographic detection of wall motion abnormalities