pance prep 2 Flashcards
what organism is MC cause of epididymitis ?
men < 40: chlamydia , followed my gonorrhea
men > 40 : E coli
defining menorrhagia
excessive cyclic uterine bleeding (>80mL) that occurs at regular intervals over several cycles, or prolonged bleeding that lasts for more than seven days
avg blood loss in a period
30-40 mL (upper limit 60-80mL)
what medication is best to treat both male-pattern baldness and erectile dysfunction from BPH
finasteride (a 5-alpha- reductase inhibitor)
- BLOCKS the conversion of testosterone into DHT which prevents baldness and lowers prostate volume
sildenafil has what MOA and what is its use?
PDE-5 inhibitor for erectile dysfunction and urinary symptoms from BPH
what antiarrhythmic can cause symptoms of hypo or hyperthyroidism?
amiodarone (structurally similar to thyroid hormones)
immunity from resolved Hep B infection versus immunization has what difference?
from infection: hep B core antibody positive
first line txt for minimal change disease
steroids: the most common cause of nephrotic syndrome in children. It presents with edema, proteinuria and hypoalbuminemia
mom positive for hep B + C, can she breastfeed?
E. While breastfeeding is encouraged, if her nipples become cracked or bleed, she should temporarily stop nursing until they are healed
MC cause of primary hyperaldosteronism? what lab values result?
bilateral adrenal hyperplasia
blood: high Na+, low K+ and renin
aldosterone: renin ratio >25
how do you differentiate primary from secondary hyperaldosteronism?
- high aldosterone and low renin (ratio >25)
2. normal aldosterone and high renin
what causes secondary hyperaldosteronism?
activation of RAAS (renal artery stenosis, aorta coarctation etc)
locations for most peptic ulcers?
lesser curve of stomach and duodenal bulb
tetany from hypoparathyroidism can be treated how?
involuntary muscle spasm : txt with IV calcium gluconate
MC location for Crohn’s disease ?
distal ileum
bald patch with “Exclamation point hairs” : Dx and txt
alopecia areata, steroids
treatment for suspected prostatitis?
- if febrile - IV abx till not febrile ( aminoglycoside + ampicillin)
- afebrile - culture UA
- do not do empiric abx b/c can lead to chronic prostatitis
1 cause of neonatal morbidity and morality
premature labor (regular contractions + dilation > 37wks)
txt for pituitary prolactin - secreting microadenoma (<10 mm)
medical treatment: bromocriptine (Sx removal only if medication fails)
preclampsia criteria
high BP on two occasions + proteinuria > 1+
what is fournier’s gangrene and what condition is if MC assoc with?
necrotizing fasciitis or gangrene affecting the external genitalia or perineum
DM
new rise in creatinine and urea nitrogen as well as the decrease in the eGFR most likely indicates
dehydration
MC type of thyroid CA
papillary
MC cause of adult nephrotic syndrome. what causes it? MC symptoms?
Membranous glomerulonephritis (idiopathic, infection, CA, meds, autoimmune, etc) MC symptom: slow onset and edema
Membranoproliferative glomerulonephritis
chronic immune mediated disease that primarily affects children and young adults. It presents with varying severity ranging from asymptomatic hematuria on urinalysis, to gross hematuria, nephrotic syndrome, or azotemia.
Focal segmental glomerulosclerosis
MC: young African American men.
asymptomatic proteinuria, or symptoms of nephrotic syndrome (edema, proteinuria, HTN)
- idiopathic or HIV infection or drug use.
molar pregnancy with gestational trophoblastic neoplasia need imaging for what possible metastasis?
lung - CXR
pyelonephritis with resolved symptoms after appropriate abx BUT persistent fever make you think of what?
perinephric abscess - need renal US +/- drainage for source control
membrane rupture, painless vaginal bleeding and fetal bradycardia.
triad of vasa previa
txt for placenta accreta
planned cesarean hysterectomy
36 weeks with positive GBS culture
Treat the woman with penicillin G at the onset of labor and continue treatment through delivery of the infant
follicular phase vs ovulatory phase
follicular: day 1-13,
ovulatory: day 14- 27
luteal phase
luteal:C. Decrease in estradiol and increase in progesterone
coincides with secretory phase
what hormone increases at the end of follicular phase?
FSH and LH (surges)
LH:FSH ratio in PCOS is increased or decreased?
increased
subacute thyroiditis (De Quarevein’s thyroiditis)
MC cause of painful thyroid.
acute inflammatory disease of the thyroid probably caused by a virus. fever and thyroid tenderness. Initial hyperthyroidism is common, sometimes followed by a transient period of hypothyroidism then euthyroidism (recovery in two weeks)
Dx of subacute (De Quervain’s) thyroiditis
elevated ESR and CRP, low iodine uptake
thyroid levels vary based on stage of dz
txt for infected breast abscess
US FNA
what pts require the pneumococcal vaccine before age 65? what is the schedule of vaccines
immunocomprimised (includes ESRD) - ages 19 +
PCV 13 followed by PPSCV 23 8 weeks later
. Loss of appetite, nausea and vomiting, headaches, fatigue, new-onset seizures, and muscle cramps indicate
acute, severe hyponatremia with levels usually below 120 mEq/L
first sign of chronic renal failure
proteinuria
