Old SAMPS Flashcards
Contraindications of HRT for postmenopausal symptoms
- pregnancy
- unexplained vaginal bleeding
- known or suspected breast CA
- active liver disease
- acute cardiovascular disease
- CAD
- stroke
- recent VTE
- migraine with aura
presentation of temporal/ giant cell arteritis
new-onset headache constitutional symptoms jaw claudication isolated visual changes upper extremity claudication Abrupt-onset headache
Jaw or tongue claudication
Limb claudication or suggestion of large vessel involvement
Prominence, beading, or diminished pulse of the temporal artery
Temporal tenderness
Upper cranial nerve palsies
Visual disturbances
management of giant cell arteritis
- higher dosages of corticosteroids: prednisolone, 40 to 60 mg per day
- urgent referral to a rheumatologist
- anti-platelet therapy: Low-dose aspirin, 81 mg per day (decreases cranial ischemic complications)
diagnosis criteria of polymyalgia rheumatica
Age > 50 years
Bilateral aching of the shoulder and/or pelvic girdle
Duration of symptoms > two weeks
Evidence of acute phase response (elevated erythrocyte sedimentation rate and C-reactive protein level)
Morning stiffness in shoulder and/or pelvic girdle > 45 minutes
symptoms of alcohol withdrawal
Autonomic hyperactivity Increased hand tremor Tongue tremor may be more reliable Insomnia Nausea or vomiting Transient visual, tactile, or auditory hallucinations or illusions Psychomotor agitation Anxiety Generalized tonic-clonic seizures
alcohol withdrawal stages
Symptoms begin within 6-24h of last drink or acute reduction in chronic alcohol
12-48h Alcohol hallucinosis (typically insects/animals in room)
6-48h Withdrawal seizures (typically tonic-clonic convulsions)
Occur in 10-30% of patients with alcohol withdrawal
3-7d (up to 14d) Withdrawal delirium (aka. delirium tremens)
Sudden-onset fluctuating attention/cognition, agitation, autonomic hyperactiviity (fever, tachycardia, hypertension, diaphoresis)
Mortality from cardiovascular complications, hyperthermia, aspiration, fluid/electrolytes disorders
Risk: Previous DT, age>30, sustatined drinking, concurrent illness, longer period between last dirnk and onset of withdrawl (>2 days)
medication drugs to treat anxiety
Tricyclic antidepressants
Tetracyclic antidepressant (Mirtazapine)
Monoamine oxidase inhibitors
Azapirones
DSM-5 symptoms of panic attack
DSM-5 symptoms of panic attack Sweating Trembling Unsteadiness, Derealization/depersonalization Excess Warmth (Hot flashes) and Excess Heart Rate Nausea Tingling, Short of Breath Fear of dying or losing control Chest pain, Chills, Choking
List FOUR of the DSM-5 Anxiety Disorders, other than Generalized Anxiety Disorder and Panic
Disorder
- Separation Anxiety Disorder
- Selective Mutism
- Specific Phobia
- Social Anxiety Disorder (Social Phobia)
- Panic Disorder
- Panic Attack (Specifier)
- Agoraphobia
- Substance/Medication-Induced Anxiety
Disorder - Anxiety Disorder Due to Another Medical
Condition - Other Specified Anxiety Disorder
- Unspecified Anxiety Disorder
risk factors of suicides
SADPERSONS -
S: Male sex A: Age (<19 or >45 years) - Different from O'Toole D: Depression P: Previous attempt E: Excess alcohol or substance use R: Rational thinking loss S: Social supports lacking O: Organized plan N: No spouse S: Sickness (Think about chronic disease!)
non-pharmacological mgt to prevent suicide
- Cognitive behavioural therapy
- Interpersonal psychotherapy
- Behavioural activation
- Mindfulness-based therapy
- Cognitive-behavioural analysis
- Problem-solving therapy
- Psychodynamic psychotherapy
- Acceptance / commitment therapy
- Motivational interviewing
- Employee family assistance
- Smoking cessation counselling
- Addictions counselling
- Financial counselling
- Family therapy
- Bereavement counselling
pediatric IV bolus amount and maintenance
bolus 20ml/kg
maintenance 4:2:1 ml/hr/kg
(4ml/kg for the first 10kg) + (2ml/kg for kg
11-20) + (1ml/kg for every kg above 20) =
hourly rate
complications of splinting or bracing
- Compartment syndrome
- ischemia
- Neurologic Injury OR Neurapraxia
- Thermal Injury
- Pressure Sores
- Infection
- Pain
- Dermatitis
- Joint stiffness
Red flags of neck pain
- Age > 50 with new symptoms
- Ripping or tearing sensation in the neck
- concurrent chest pain / cardiac history
- Weight Loss, night sweats
- Immunosuppressed
- Intravenous drug use
- Neurological symptoms or signs, eg. severe h/a
- Paresthesias
- Vision changes
- history of malignancy
- recent trauma
specific concern of neck pain in a 40s female with history of juvenile rheumatoid arthritis
atlanto-axial disruption
