More Questions Flashcards
Management of ER +, PR +, HER-2 negative breast cancer w/ low risk of recurrence
Radiation + Tamoxifen
Tx for patients w/ advanced ovarian cancer after optimal treatment and surgical resection
IV and Intraperitoneal cisplatin and paclitaxel
Patients w/ increased breast density
At increased risk for breast cancer (20-25%), HOWEVER, normal cancer monitoring is recommended
If other coexisting risk factors are present, then patients need breast MRI
Diffuse idiopathic skeletal hyperostosis
Flowing, linear calcifications and ossifications on the anterolateral aspects of the vertebral bodies
Typically see upward pointing spurs in the lumbar spine; downward in cervical
Relapsing, remitting HAV
Pt who develops HAV symptoms again 3 months after infection resolved
Typically milder, but can be assoc. w/ nephritis, arthralgia, vasculitis, and cryoglobulinemia
Consideration prior to starting allopurinol
HLA-B 5801 allele which can cause DRESS
Pts to screen include Thai, Chinese, Korean, and CKD pts
Test for Alzheimer’s in pts w/ MCI
LP; shows decreased AB42 peptide and increased tau protein
> 80% sensitivity and specificity
Other EKG findings of hypercalcemia
PR prolongation
Increased QRS amplitude
T wave upslope
Skin changes of amyloidosis
Pinch purpura (bruising w/ slight pressure). ecchymoses around eyes (raccoon eyes), yellow, waxy pearls in periorbital area
Indications for AV replacement w/ SEVERE regurgitation
Symptomatic
LVEF <50%
LV dilation
If absent, then just repeat echo q6-12months
Tx of MSSA osteomyelitis w/ infected hardward
Penicillin + Rifampin
-Helps to eradicate potential biofilms formed on the hardware
Amyopathci dermatomyositis
Experience heliotrope rash, Gottron papules, shawl sign, but w/o clinical or lab evidence of muscle disease
-Pts still at increased risk of malignancy and pulmonary fibrosis
Shawl sign
Widespread, flat, and red area on the upper back and shoulders associated w/ dermatomyositis
Respiratory-bronchiolitis associated ILD
Imaging in smokers reveal centrilobular micronodules w/ tan-pigmented macrophages on biopsy
-Pts often asymptomatic and in 4-5th decade of smoking
Pts w/ afib and HOCM
Needs anticoagulation
Microscopic colitis
Typically presents in the setting of months of chronic, watery diarrhea unresponsive to medical therapy
Tx: Stop offending meds, loperamide, budesonide last line but very effective
Primary angiitis of the CNS
Presents w/ gradual, progressive neurologic sx like HA, cognitive deficits, and other unusual focal findings
Labs: Unremarkable but LP shows lympocytic pleocytosis and increased protein
Cerebral angiogram CAN MAYBE show beading
Brain bx shows granulomatous vasculitis but only has 50% sensitivity
Tx: High dose glucocorticoids + cyclophosphamide for 3-6months followed by azathioprine maintenance therapy
Indications for kidney biopsy
Glomerular hematuria
Severely increased albuminuria
Acute or Chronic Kidney Disease of unclear cause
Kidney transplant dysfnxn or monitoring
Myoclonic seizure
Consists of one, single jerk of the entire body lasting approx 1 sec; pts retain awareness and have no post-ictal confusions
Tx of hypertensive emergency
Lower BP by no more than 25% in first hour; lower SBP to 160 within 6 hrs
Tx for gouty cellulitis
Prednisone
Adrenal mass indicators of malignancy
> 4cm
Density >10 Houndsfield units
Absolute contrast washout <50% after 10 mins
Labs to monitor in hypoparathyroidism
Calcium
Mg
Cr
Urine calcium-many patients will have low levels
First step in management of prepatellar bursitis
ASPIRATE