Previous notes Flashcards
The most common side effect of ASA is tinnitus
The most common side effect of ASA is tinnitus
Prophylactic ASA use: -males 45- 79 yrs. - females 55-79 yrs.
Prophylactic ASA use: -males 45- 79 yrs. - females 55-79 yrs.
TMP-sulfa may increase effect of warfarin causing bleeding
TMP-sulfa may increase effect of warfarin causing bleeding
Aortic mechanical valve: INR 2.0-3.0. Mitral mechanical valve: INR 2.5-3.5.
Aortic mechanical valve: INR 2.0-3.0. Mitral mechanical valve: INR 2.5-3.5.
Digoxin toxicity may produce thrombocytopenia and delirium
Digoxin toxicity may produce thrombocytopenia and delirium
thiazide and furosemide (loop) are common cause of hypokalemia
thiazide and furosemide (loop) are common cause of hypokalemia
HCTZ is contraindicated in gout
HCTZ is contraindicated in gout
Pericartitis: chest pain, widespread st changes and friction rub. First-line treatment are NASAIS/ASA, second-line are steroids.
Pericartitis: chest pain, widespread st changes and friction rub. First-line treatment are NASAIS/ASA, second-line are steroids.
Indication for prophylaxis for endocarditis: prosthetic valve, prior endocarditis and cyanotic cardiopathies
Indication for prophylaxis for endocarditis: prosthetic valve, prior endocarditis and cyanotic cardiopathies
Treatment to symptomatic aortic stenosis is cx
Treatment to symptomatic aortic stenosis is cx
Asymptomatic aortic stenosis treatment are serial echos and avoid exertion
Asymptomatic aortic stenosis treatment are serial echos and avoid exertion
IV drug users typically have endocarditis on tricuspid valve
IV drug users typically have endocarditis on tricuspid valve
Hypertrophic cardiomyopathy (hypertrophy of LV outflow tract-septum produces a systolic murmur that increases with valsalva and decreases with handgrip (squeeze one’s hand)
Hypertrophic cardiomyopathy (hypertrophy of LV outflow tract-septum produces a systolic murmur that increases with valsalva and decreases with handgrip (squeeze one’s hand)
hypertrophic cardiomyopathy is the most common cause of death in young athletes
hypertrophic cardiomyopathy is the most common cause of death in young athletes
Most common cause of death within 1 year after cardiac transplantation is infection. After 5 years is allograft CAD followed by malignancy.
Most common cause of death within 1 year after cardiac transplantation is infection. After 5 years is allograft CAD followed by malignancy.
Diastolic failure= normal EF failure
Diastolic failure= normal EF failure
Pulmonary edema treatment: LMNOP (lasix, morphine, nitroglycerin, oxygen, position)
Pulmonary edema treatment: LMNOP (lasix, morphine, nitroglycerin, oxygen, position)
Digoxin enhances the symptoms of CHF, but not the mortality. ACEI lowers mortality
Digoxin enhances the symptoms of CHF, but not the mortality. ACEI lowers mortality
Circunflex occlusion: I and AVL changes. Right coronary artery occlusion: II, II, AVF LAD occlusion: V1-V6
Circunflex occlusion: I and AVL changes. Right coronary artery occlusion: II, II, AVF LAD occlusion: V1-V6
ST elevation in II, II and AVF along with ST depression in V1-V3, it is more likely the left circumflex to be occluded.
ST elevation in II, II and AVF along with ST depression in V1-V3, it is more likely the left circumflex to be occluded.
Mayor risk for cardiovascular disease (Framingham score): age, cholesterol (total and HDL), smoking, HTN and DM. After calculate the risk, take into account family history, which made double it
Mayor risk for cardiovascular disease (Framingham score): age, cholesterol (total and HDL), smoking, HTN and DM. After calculate the risk, take into account family history, which made double it
Women have worst outcome after a MI
Women have worst outcome after a MI
Sumatriptan (for cluster headache) is contraindicated in prinzmetal angina because it produces vasoconstriction
Sumatriptan (for cluster headache) is contraindicated in prinzmetal angina because it produces vasoconstriction
Torsade de points occur in patients with baseline long QT syndrome. Can be treated with magnesium.
Torsade de points occur in patients with baseline long QT syndrome. Can be treated with magnesium.
Supraventricular tach: first carotid massage, if it doesn’t work ADENOSINE
Supraventricular tach: first carotid massage, if it doesn’t work ADENOSINE
AF if unstable, electrical cardioversion
AF if unstable, electrical cardioversion
AF treatment: RACE (rate control, anticoagulation, cardioversion and etiology)
AF treatment: RACE (rate control, anticoagulation, cardioversion and etiology)
AF: Anticoagulation if CHADS2 > 1, fi not ASA. Rate control with beta blocker or CCB (diltiazem, verapamil)
AF: Anticoagulation if CHADS2 > 1, fi not ASA. Rate control with beta blocker or CCB (diltiazem, verapamil)
Flutter, if unstable do electrical cardioversion, if not beta blocker and amiodarone/sotalol
Flutter, if unstable do electrical cardioversion, if not beta blocker and amiodarone/sotalol
Albumin is decreased during sepsis.
Albumin is decreased during sepsis.
preferred vasopressors in sepsis are norepinefrina and dopamine
preferred vasopressors in sepsis are norepinefrina and dopamine
SCLC paraneoplastic syndome: SIADH Squamous carcinoma lung cancer: Hypercalcemia
SCLC paraneoplastic syndome: SIADH Squamous carcinoma lung cancer: Hypercalcemia
Surgery not usually performed for SCLC since it is generally not-curable
Surgery not usually performed for SCLC since it is generally not-curable
Relación lecitina/esfingomielina mayor de 2 se correlaciona con madurez pulmonar del feto
Relación lecitina/esfingomielina mayor de 2 se correlaciona con madurez pulmonar del feto
When a PE is suspected and CT is contraindicated, ventilation perfusion scan must be done
When a PE is suspected and CT is contraindicated, ventilation perfusion scan must be done
Rifampicin interfere with the warfarin action
Rifampicin interfere with the warfarin action
Sarcoidosis: disregulation of immune system that forms non-caseating granulomas which affect mainly the lungs’ lymphatic nodules (bilateral hilar lymphadenopathy). If no symptoms, observation. If symptoms, corticosteroids.
Sarcoidosis: disregulation of immune system that forms non-caseating granulomas which affect mainly the lungs’ lymphatic nodules (bilateral hilar lymphadenopathy). If no symptoms, observation. If symptoms, corticosteroids.
Drugs related to Pulmonary fibrosis: bleomycin, anphotericine andcarbamazepine
Drugs related to Pulmonary fibrosis: bleomycin, anphotericine andcarbamazepine
Copious foul smelling sputum. clubbing and hemoptysis are clues for bronchiectasis
Copious foul smelling sputum. clubbing and hemoptysis are clues for bronchiectasis
Clubbing is not typical of COPD
Clubbing is not typical of COPD
HCTZ has cross allergy with sulfas
HCTZ has cross allergy with sulfas
MDI shorts stays in the ER, they are also as effective as nebulization, but with best cost
MDI shorts stays in the ER, they are also as effective as nebulization, but with best cost
Inhaled corticosteroid is used to suppress the symptoms of chronic persistent asthma rather than a acute attack.
Inhaled corticosteroid is used to suppress the symptoms of chronic persistent asthma rather than a acute attack.
When a patient has a normal or elevated CO2 level during acute asthma is severe disease and he/she may undergo into respiratory failure.
When a patient has a normal or elevated CO2 level during acute asthma is severe disease and he/she may undergo into respiratory failure.
Inhaled corticosteroids are safe in pregnancy
Inhaled corticosteroids are safe in pregnancy
- Beta blockers type 1 selective: act on heart - Non-selective beta blockers: contraindicated in asthma (labetalol)
- Beta blockers type 1 selective: act on heart - Non-selective beta blockers: contraindicated in asthma (labetalol)
The efficacy of oral prednisone has been shown to be equivalent to IV methylprednisolone.
The efficacy of oral prednisone has been shown to be equivalent to IV methylprednisolone.
Carotid stenosis: > 70% meds + surgery 50-99% meds (some selected patients sx) < 50% meds (no benefit from sx)
Carotid stenosis: > 70% meds + surgery 50-99% meds (some selected patients sx) < 50% meds (no benefit from sx)
LDL goal for DM, CAD, AAA and PAD is 2 mmol/l (77 mg/dl)
LDL goal for DM, CAD, AAA and PAD is 2 mmol/l (77 mg/dl)
Ruptures AAA: OR ASAP!!
Ruptures AAA: OR ASAP!!
Consider OR for AAA when > 5.5 cm of diameter
Consider OR for AAA when > 5.5 cm of diameter
Chest pain, PMHx Marfan’s, difference n SBP between arms and wide mediastinum in Rx= Aortic Dissection. Treatment if type A: OR, type B: beta blocker
Chest pain, PMHx Marfan’s, difference n SBP between arms and wide mediastinum in Rx= Aortic Dissection. Treatment if type A: OR, type B: beta blocker
The most beneficial for peripheral vascular disease is strict exercise training program and smoke cessation .
The most beneficial for peripheral vascular disease is strict exercise training program and smoke cessation .
Most effective daily dose for fracture prevention in postmenopausal women: 800 IU via D and 1200 mg calcium
Most effective daily dose for fracture prevention in postmenopausal women: 800 IU via D and 1200 mg calcium
ACE-inhibitor in general are the best option for diabetic patients.
ACE-inhibitor in general are the best option for diabetic patients.
HCTZ may preserve bone density
HCTZ may preserve bone density
Mono therapy for hypertension in black patients is more likely to consist of HCTZ or CCB
Mono therapy for hypertension in black patients is more likely to consist of HCTZ or CCB
HCTZ should be avoided in gout patients
HCTZ should be avoided in gout patients
Avoid beta-blockers in cocaine overdose
Avoid beta-blockers in cocaine overdose
Clonidine, example of rebound hypertension
Clonidine, example of rebound hypertension
Frost-Line therapy for proteinuric kidney are ACEI or ARB
Frost-Line therapy for proteinuric kidney are ACEI or ARB
Prophylactic therapy for cluster headache: verapamil, lithium, prednisolone or methysergide.
Prophylactic therapy for cluster headache: verapamil, lithium, prednisolone or methysergide.
Varenicline is the most effective pharmacological option in smoke cessation
Varenicline is the most effective pharmacological option in smoke cessation
Blacks are 1.5 times as likely as whites to develop prostate cancer
Blacks are 1.5 times as likely as whites to develop prostate cancer
Percentage of canadian population with colonic polyps: 30-40-50 by 50-60-70
Percentage of canadian population with colonic polyps: 30-40-50 by 50-60-70
Colon cancer screening starts at 50 y. In family hereditary non-polyposis colorectal cancer, at 25
Colon cancer screening starts at 50 y. In family hereditary non-polyposis colorectal cancer, at 25
Child neglect is the most common form of child abuse in canada
Child neglect is the most common form of child abuse in canada
An agitated patient with with a brief psychotic episode must be first sedated with a benzodiazepine before giving an antipsychotic.
An agitated patient with with a brief psychotic episode must be first sedated with a benzodiazepine before giving an antipsychotic.
Quetiapina and clozapine are the only atypic antipsychotics that are not related with parkinsonism.
Quetiapina and clozapine are the only atypic antipsychotics that are not related with parkinsonism.
- Schizofrenia: psychotic symptoms for more than 6 months. - Schizophreniform: psychotic symptoms for 1-6 months. - Brief psychotic disorder: psychotic symptoms for less than 1 month - Schizoafective: psychotic symptoms+ mood - Schizoid personality: life-time pattern of social withdraw and no desire for social relations
- Schizofrenia: psychotic symptoms for more than 6 months. - Schizophreniform: psychotic symptoms for 1-6 months. - Brief psychotic disorder: psychotic symptoms for less than 1 month - Schizoafective: psychotic symptoms+ mood - Schizoid personality: life-time pattern of social withdraw and no desire for social relations
TCA overdose produces respiratory depression, therefore on ABGs hypoxia, hypercapnia and acidosis
TCA overdose produces respiratory depression, therefore on ABGs hypoxia, hypercapnia and acidosis
formula de parkland: 4cc/kg/%quemado pasar la mitad en 8 horas y el resto en 16 horas.
formula de parkland: 4cc/kg/%quemado pasar la mitad en 8 horas y el resto en 16 horas.
Any medication that affects the circulation of the skin (clonidina) or the shivering mechanism can predispose to hypothermia.
Any medication that affects the circulation of the skin (clonidina) or the shivering mechanism can predispose to hypothermia.
To prevent calcium stones, give thiazide diuretics (they promote the reabsorption of calcium into the blood stream)
To prevent calcium stones, give thiazide diuretics (they promote the reabsorption of calcium into the blood stream)
kidney stones: - 80% calcium oxalate - 10% struvite - 10% uric acid
kidney stones: - 80% calcium oxalate - 10% struvite - 10% uric acid
the most common cause of abnormal uterine bleeding us anovulation.
the most common cause of abnormal uterine bleeding us anovulation.
Placenta previa: painless,bright red vaginal bleeding
Placenta previa: painless,bright red vaginal bleeding
Most common cause of epistaxis is trauma
Most common cause of epistaxis is trauma
If a stroke happens while the patient is on ASA, it must be switched to clopidrogel.
If a stroke happens while the patient is on ASA, it must be switched to clopidrogel.
In stroke only treat HTN if > 200/120
In stroke only treat HTN if > 200/120
Entre menos síntomas se presenten el compromiso es más distal
Entre menos síntomas se presenten el compromiso es más distal
Endarterectomy with carotid occlusion greater than 70%
Endarterectomy with carotid occlusion greater than 70%
Hypocalcemia is related with prolonged QT
Hypocalcemia is related with prolonged QT
Vitamin D elevates the absortion of both calcium and phosphorus.
Vitamin D elevates the absortion of both calcium and phosphorus.
initial treatment of hypercalcemia is hydration, once the patient is well hydrated, one can add furosemide.
initial treatment of hypercalcemia is hydration, once the patient is well hydrated, one can add furosemide.
Lithium can cause primary hyperPTH
Lithium can cause primary hyperPTH
Thiazides can exacerbate hypercalcemia
Thiazides can exacerbate hypercalcemia
Primary hyperPTH and malignancy are the most common causes of hypercalcemia, accounting for 90% of causes.
Primary hyperPTH and malignancy are the most common causes of hypercalcemia, accounting for 90% of causes.
Insulin and salbutamol lower the K+
Insulin and salbutamol lower the K+
ACE inhibitor can cause hyperkalemia
ACE inhibitor can cause hyperkalemia
Asymptomatic patient without risk factors but with a surprising hyperkalemia results, before doing treatment, it is necessary to repeat the test
Asymptomatic patient without risk factors but with a surprising hyperkalemia results, before doing treatment, it is necessary to repeat the test
The most commun cause of hypoglycemia in a previous stable patient is renal disease
The most commun cause of hypoglycemia in a previous stable patient is renal disease
C peptide is used to measure the amount of endogenous insulin that is synthetized
C peptide is used to measure the amount of endogenous insulin that is synthetized
whipple triad: symptoms of hypoglycemia, low glucose levels and improvement of symptoms after administration of glucose
whipple triad: symptoms of hypoglycemia, low glucose levels and improvement of symptoms after administration of glucose
HCO3 indicator of severity in DKA. Treatment of DKA: - Insuline (short acting/regular): bolus of 0.2 U/kg, then 0.1 U/kg/hr - K+: 20 mEq per 1lt of iv fluids - IV fluids NS
HCO3 indicator of severity in DKA. Treatment of DKA: - Insuline (short acting/regular): bolus of 0.2 U/kg, then 0.1 U/kg/hr - K+: 20 mEq per 1lt of iv fluids - IV fluids NS
Tratamiento anticoagulante se debe continuar por 6 meses luego de parto
Tratamiento anticoagulante se debe continuar por 6 meses luego de parto
dosis inicial de heparina no fracionada en tvp: 80 mg/kg. Se continua bajo una fusión de 18 mg/kg/hr
dosis inicial de heparina no fracionada en tvp: 80 mg/kg. Se continua bajo una fusión de 18 mg/kg/hr
First DVT: tx for 3 months First DVT + risk fx: consider indefinite Recurrent DVT: indefinite therapy
First DVT: tx for 3 months First DVT + risk fx: consider indefinite Recurrent DVT: indefinite therapy
NSAID and high-dose of ASA should be avoided in CHF because they can cause fluid retention
NSAID and high-dose of ASA should be avoided in CHF because they can cause fluid retention
Although digoxin improves EF and symptoms, it doesn’t improve survival in CHF
Although digoxin improves EF and symptoms, it doesn’t improve survival in CHF
Nitroprusside, prazosin, ACE inhibitors and ARA II inhibitors reduce both preload and after load
Nitroprusside, prazosin, ACE inhibitors and ARA II inhibitors reduce both preload and after load
amiodarone treatment is associated with interstitial lung disease and thyroid disorders
amiodarone treatment is associated with interstitial lung disease and thyroid disorders
Most common medication to control rate in AFib are beta blockers
Most common medication to control rate in AFib are beta blockers
Taquicardia supraventricular: masaje carotideo + adenosina (seguida en bolo seguida de SSN). Si luego de dos dosis de adenosina no funciona, calcionatagonista o beta bloqueador
Taquicardia supraventricular: masaje carotideo + adenosina (seguida en bolo seguida de SSN). Si luego de dos dosis de adenosina no funciona, calcionatagonista o beta bloqueador
A specific antibody called IgE is responsible for the adverse reactions in people with allergies.
A specific antibody called IgE is responsible for the adverse reactions in people with allergies.
Anaphylactic shock from latex allergy has been associated with myelomeningocele
Anaphylactic shock from latex allergy has been associated with myelomeningocele
Most common cause of syncope is vasovagal
Most common cause of syncope is vasovagal
Syncope with exercise is a manifestation of organic heart disease in which cardiac output is fixed and does not rise like in aortic stenosis.
Syncope with exercise is a manifestation of organic heart disease in which cardiac output is fixed and does not rise like in aortic stenosis.
Valproic acid is the agent of choice in grand mal seizure (tonic.clonic)
Valproic acid is the agent of choice in grand mal seizure (tonic.clonic)
Most frequent cause of seizure in elderly is stroke
Most frequent cause of seizure in elderly is stroke
Patients with a history of kidney stones should not take topiramate
Patients with a history of kidney stones should not take topiramate
In back pain continue daily activity rather than bed resto helps to recovery
In back pain continue daily activity rather than bed resto helps to recovery
The most common cause for cystic enlargement of the ovary in a reproductive age woman us a functional cyst. Observation and follow-up are needed.
The most common cause for cystic enlargement of the ovary in a reproductive age woman us a functional cyst. Observation and follow-up are needed.
The majority of ovarian cyst diagnosed in early pregnancy represent a corpus lute cyst.
The majority of ovarian cyst diagnosed in early pregnancy represent a corpus lute cyst.
Medial meniscal lesions are more common than lateral ones.
Medial meniscal lesions are more common than lateral ones.
Paciente con caída y dolor en tabaquera anatómica, se sospecha fx de escamondes. Si la rx es normal, se inmoviliza con una thumb spica de todas maneras y se repite la rx una semana después
Paciente con caída y dolor en tabaquera anatómica, se sospecha fx de escamondes. Si la rx es normal, se inmoviliza con una thumb spica de todas maneras y se repite la rx una semana después
Si es atleta o futbolista joven con un cuadro parecido a una claudicación intermitente puede ser un sd compartimentos crónico
Si es atleta o futbolista joven con un cuadro parecido a una claudicación intermitente puede ser un sd compartimentos crónico
pain in passive extension: compartment syndrome until proven otherwise
pain in passive extension: compartment syndrome until proven otherwise
In the case of gross hematuria, the GU system is investigated from distal to proximal
In the case of gross hematuria, the GU system is investigated from distal to proximal
Cardiac tamponade: - Beck triad (hypotension, muffled heart sounds and distended neck veins) - Pulsus paradoxus.
Cardiac tamponade: - Beck triad (hypotension, muffled heart sounds and distended neck veins) - Pulsus paradoxus.
Pneumothorax < 15-20%, observation and oxygen
Pneumothorax < 15-20%, observation and oxygen
nasal septal deviation is the most likely cause of chronic unilateral obstruction
nasal septal deviation is the most likely cause of chronic unilateral obstruction
Leading cause of death in Canada is cancer, followed by cardiovascular diseases
Leading cause of death in Canada is cancer, followed by cardiovascular diseases
Lung cancer is the leading cause of deaths in Canada, followed by colorectal, breast and prostate
Lung cancer is the leading cause of deaths in Canada, followed by colorectal, breast and prostate
1/3 of female deaths are due to cardiovascular diseases (1st) and stroke (2nd)
1/3 of female deaths are due to cardiovascular diseases (1st) and stroke (2nd)
Decision Making: 1. What the patient says 2. What the patient has written 3. Health care proxy (previously appointed by the patient) 4. Next of kin or close friend 5. Hospital ethics committee or courts
Decision Making: 1. What the patient says 2. What the patient has written 3. Health care proxy (previously appointed by the patient) 4. Next of kin or close friend 5. Hospital ethics committee or courts
Permission for release of patient information should always be in writing.
Permission for release of patient information should always be in writing.
Physicians have the duty to warn and protect intended or potential victims.
Physicians have the duty to warn and protect intended or potential victims.
Canada’s health care system budget: 1. Hospitals 30% 2. Drugs 17% 3. Physicians 15% 4. Other professionals 10%
Canada’s health care system budget: 1. Hospitals 30% 2. Drugs 17% 3. Physicians 15% 4. Other professionals 10%
Public health unit: enforcement of water and food regulation, local environmental risk, follow-up reportable disease.
Public health unit: enforcement of water and food regulation, local environmental risk, follow-up reportable disease.
Lower rates of breast, lung, colorectal and prostate cancers are found among First Nations population
Lower rates of breast, lung, colorectal and prostate cancers are found among First Nations population
Asthma is the most common illness related with workplace
Asthma is the most common illness related with workplace
Benzeno produce leucemia, mieloma multiple y anemia aplásica.
Benzeno produce leucemia, mieloma multiple y anemia aplásica.
La exotoxina del S Aureus está presente en la mayoría de casos de diarrea, generalmente asociado a jamones, pudding, derivados del huevo, pastelería y sandwiches.
La exotoxina del S Aureus está presente en la mayoría de casos de diarrea, generalmente asociado a jamones, pudding, derivados del huevo, pastelería y sandwiches.
Waterborne diarrhea: Norwalk virus. Associated with cruises, nursing homes and summer camps
Waterborne diarrhea: Norwalk virus. Associated with cruises, nursing homes and summer camps
E. coli: presente en carnes mal cocinadas
E. coli: presente en carnes mal cocinadas
Most important preventive management for stroke is control of hypertension
Most important preventive management for stroke is control of hypertension
Attack rate: affected / total population in risk
Attack rate: affected / total population in risk
A la hora de evaluar métodos diagnósticos se debe tener en cuenta: valor predictivo postivo, valor predictivo negativo y likelihood ratio.
A la hora de evaluar métodos diagnósticos se debe tener en cuenta: valor predictivo postivo, valor predictivo negativo y likelihood ratio.
When the cut-off point is lowered, test sensivility increases and specificity decreases.
When the cut-off point is lowered, test sensivility increases and specificity decreases.
valor preductivo postivo está dorectamente relacionado con la prevalencia de una enfermedad
valor preductivo postivo está dorectamente relacionado con la prevalencia de una enfermedad
NNT = 1/ARR (absolute risk reduction)
NNT = 1/ARR (absolute risk reduction)
Odds ratio: AxD/BxC
Odds ratio: AxD/BxC
Epidemiological triad: host, agent and environment.
Epidemiological triad: host, agent and environment.
para hablar de incidencia se necesita el dato de la cuanta población está en riesgo.
para hablar de incidencia se necesita el dato de la cuanta población está en riesgo.
Si una conclusion no es estadisticamente significativa es porque la diferencia entre las intervenciones puede ser debida al azar.
Si una conclusion no es estadisticamente significativa es porque la diferencia entre las intervenciones puede ser debida al azar.
Outbreak is synonym of epidemic
Outbreak is synonym of epidemic
Durante la fase 2 un nuevo medicamento se prueba en individuos enfermos,se prueba su eficacia y su seguridad. Es la fase donde se descartan la mayoría.
Durante la fase 2 un nuevo medicamento se prueba en individuos enfermos,se prueba su eficacia y su seguridad. Es la fase donde se descartan la mayoría.
If the value of 1 is not within the 95% of confidence interval, then the odds ratio is statistically significant at the 5% level (p<0.05)
If the value of 1 is not within the 95% of confidence interval, then the odds ratio is statistically significant at the 5% level (p<0.05)
Case-control study is relatively inexpensive and is used for rare diseases.
Case-control study is relatively inexpensive and is used for rare diseases.
Prospective cohort studies: measuring from the exposure to the future outcome. (looking forward) Level of evidence: I (RCT), II (Prospective cohort), III (case-control)
Prospective cohort studies: measuring from the exposure to the future outcome. (looking forward) Level of evidence: I (RCT), II (Prospective cohort), III (case-control)
Enter más uniforme sea la chorote, mejor (patients at an early uniform point in the course of their disease)
Enter más uniforme sea la chorote, mejor (patients at an early uniform point in the course of their disease)
Cross-sectional studies are used to estimate prevalence at a point in time
Cross-sectional studies are used to estimate prevalence at a point in time
Observational studies involve neither manipulation of the exposure nor randomization of the study subjects.
Observational studies involve neither manipulation of the exposure nor randomization of the study subjects.
Cuando se aumenta el punto de cohorte de una prueba, su sensibilidad baja y su especificidad aumenta.
Cuando se aumenta el punto de cohorte de una prueba, su sensibilidad baja y su especificidad aumenta.
- Lead- time: tiempo entre la detección de una condición gracias al tamizaje y el momento en el que la enfermedad se hubiera detectado sin tamizaje. - lead-time bias: al detectar una enfermedad tempranamente se produce un aparente aumento en la supervivencia, pero en realidad esto está sesgado por el tamizaje y no se representa un real aumento de la supervivencia.
- Lead- time: tiempo entre la detección de una condición gracias al tamizaje y el momento en el que la enfermedad se hubiera detectado sin tamizaje. - lead-time bias: al detectar una enfermedad tempranamente se produce un aparente aumento en la supervivencia, pero en realidad esto está sesgado por el tamizaje y no se representa un real aumento de la supervivencia.
Most common cause of mortality in twin pregnancies are respiratory distress syndrome
Most common cause of mortality in twin pregnancies are respiratory distress syndrome
Cambios en las edades de ingreso a los programas de tamizaje pueden producir cambios en las tasas de incidencia.
Cambios en las edades de ingreso a los programas de tamizaje pueden producir cambios en las tasas de incidencia.
most common cause of perinatal mortality is prematurity.
most common cause of perinatal mortality is prematurity.
Meperidina debe ser evitado en pacientes mayores
Meperidina debe ser evitado en pacientes mayores
Primidone (prefered in elderly) and propranolol (prefered in youth) are the cornerstones of maintenance therapy for essential tremor.
Primidone (prefered in elderly) and propranolol (prefered in youth) are the cornerstones of maintenance therapy for essential tremor.
Acute treatment of dystonia: benztropine or diphenhydramine.
Acute treatment of dystonia: benztropine or diphenhydramine.
60% de los tumores cerebrales en niños se dan en fosa posterior. El más común es el astrocitoma de bajo grado y el maligno más común es el meduloblastoma.
60% de los tumores cerebrales en niños se dan en fosa posterior. El más común es el astrocitoma de bajo grado y el maligno más común es el meduloblastoma.
Dentro del manejo de coma de causa indeterminada, no se usan corticoides de rutina
Dentro del manejo de coma de causa indeterminada, no se usan corticoides de rutina
a(P)raxia: daño en (P)arietal
a(P)raxia: daño en (P)arietal
- Sensory ataxia (lesion of dorsal column tracts): Romberg is positive, walk in narrow base and DO HAVE loss in vibration and propiopception. - Cerebellar ataxia: negative romberg, walk in a wilde baseDO NOT have loss in vibration and propipception
- Sensory ataxia (lesion of dorsal column tracts): Romberg is positive, walk in narrow base and DO HAVE loss in vibration and propiopception. - Cerebellar ataxia: negative romberg, walk in a wilde baseDO NOT have loss in vibration and propipception
Ante una parálisis del III par y un paciente con cefalea, se debe pensar en la existencia de un aneurisma a nivel del círculo de Willis.
Ante una parálisis del III par y un paciente con cefalea, se debe pensar en la existencia de un aneurisma a nivel del círculo de Willis.
El factor de riesgo más importante para hemorragia intracerebral es HTN
El factor de riesgo más importante para hemorragia intracerebral es HTN
Ante la sospecha de hemorragia subraracnoidea se hace un TAC sin contrste, si este es negativo, pero la clínica sigue igual de sugestiva, se debe realizar una punción lumbar la cual para ser positiva debe presentar sangre o xantocromia.
Ante la sospecha de hemorragia subraracnoidea se hace un TAC sin contrste, si este es negativo, pero la clínica sigue igual de sugestiva, se debe realizar una punción lumbar la cual para ser positiva debe presentar sangre o xantocromia.
Ependymoma is the most common tumor found within the ventricular system
Ependymoma is the most common tumor found within the ventricular system
Solitary metastasic lesion on the brain can me managed with surgery followed with whole brain radiotherapy. Multiple lesions are treated only with whole brain radiotherapy. Unresectable brain metastasis is treated with irradiation of the mass.
Solitary metastasic lesion on the brain can me managed with surgery followed with whole brain radiotherapy. Multiple lesions are treated only with whole brain radiotherapy. Unresectable brain metastasis is treated with irradiation of the mass.
Most common primary sources of metastatic brain tumors: lung and breast
Most common primary sources of metastatic brain tumors: lung and breast
Normal pressure hydrocephalus (DIA) - Dementia/ memor loss - Incontinence - Ataxia of gait
Normal pressure hydrocephalus (DIA) - Dementia/ memor loss - Incontinence - Ataxia of gait
CSF removal is the diagnostic gold standard of normal pressure hydrocephalus
CSF removal is the diagnostic gold standard of normal pressure hydrocephalus
Cushing’s Triad: -HTN -Bradycardia -Abnormal respiratory pattern
Cushing’s Triad: -HTN -Bradycardia -Abnormal respiratory pattern
Young woman with motor, coodinarion lack, dysphagia and visual symptoms (optic neuritis) that progressively worsen, specially in hot weather: Multiple Sclerosis.
Young woman with motor, coodinarion lack, dysphagia and visual symptoms (optic neuritis) that progressively worsen, specially in hot weather: Multiple Sclerosis.
Multiple Sclerosis: - Limb weakness - Paresthesias - Diplopia - Optic neuritis - Urinary incontinence - Vertigo
Multiple Sclerosis: - Limb weakness - Paresthesias - Diplopia - Optic neuritis - Urinary incontinence - Vertigo
In stroke do not lower the blood pressure unless HTN is severe (> 220/120)
In stroke do not lower the blood pressure unless HTN is severe (> 220/120)
Stroke of posterior cerebral artery produces short-memory impairment and cortical blindness or homonimus hemianospsia.
Stroke of posterior cerebral artery produces short-memory impairment and cortical blindness or homonimus hemianospsia.
CHADS2 (CHF, hypertension, age > 75, DM, and history of stroke or TIA
CHADS2 (CHF, hypertension, age > 75, DM, and history of stroke or TIA
Carotid stenosis greater than 70% is a good candidate for endarterectomy
Carotid stenosis greater than 70% is a good candidate for endarterectomy
Narcolepsy (sudden loss of muscle tone) is treated with methylphenidate.
Narcolepsy (sudden loss of muscle tone) is treated with methylphenidate.
Cipap is the treatment of choice in sleep apnea, weight loss and sleep hygiene are coadyuvant treatments.
Cipap is the treatment of choice in sleep apnea, weight loss and sleep hygiene are coadyuvant treatments.
Any condition that lowers PaCO2 (high altitude or heart failure) will worsen central sleep apnea
Any condition that lowers PaCO2 (high altitude or heart failure) will worsen central sleep apnea
Restless Leg Syndrome, can be produced by iron deficiency, hence iron supplementation is part of the treatment. Also dopaminergic agonist.
Restless Leg Syndrome, can be produced by iron deficiency, hence iron supplementation is part of the treatment. Also dopaminergic agonist.
Acostarse y levantarse a la misma hora siempre ayuda a tener un sueño reparador.
Acostarse y levantarse a la misma hora siempre ayuda a tener un sueño reparador.
Cluster type headache: - Acute Tx: sumatriptan - Prophylaxus: verapamil, lithium, prenisolone
Cluster type headache: - Acute Tx: sumatriptan - Prophylaxus: verapamil, lithium, prenisolone
Migraine prophylaxis: - Frist line: Beta-blokers (Propanolol) - Second line: TCA (Amitriptyline) - Third line: Anticonvulsivants (valproate, topiramate)
Migraine prophylaxis: - Frist line: Beta-blokers (Propanolol) - Second line: TCA (Amitriptyline) - Third line: Anticonvulsivants (valproate, topiramate)
Ergotamines are contraindicated in pregnancy as well as in women of childbearing age. It produces vasocontriction of the uterine vessels leading to intrauterine growth restriction or abrotion.
Ergotamines are contraindicated in pregnancy as well as in women of childbearing age. It produces vasocontriction of the uterine vessels leading to intrauterine growth restriction or abrotion.
Postherpetic neurlagia can be treated with TCA (amitriptyline, nortriptyline) or antoconvulsant (pregabaline, gabapentine)
Postherpetic neurlagia can be treated with TCA (amitriptyline, nortriptyline) or antoconvulsant (pregabaline, gabapentine)
most important factor for developing postherpetic neuralgia is old age
most important factor for developing postherpetic neuralgia is old age
Trigeminal Neuralgia treatmet: - First line: carbamazepine or oxcarbazepine. - Second line: lamotrigine.
Trigeminal Neuralgia treatmet: - First line: carbamazepine or oxcarbazepine. - Second line: lamotrigine.
For the diagnosis of neuropathic pain it’s necessary to think about positive an negative symptoms.
For the diagnosis of neuropathic pain it’s necessary to think about positive an negative symptoms.
Duchenne muscular dystrophy is inherited in a X-linked recessive pattern.
Duchenne muscular dystrophy is inherited in a X-linked recessive pattern.
Children under 1 year should not be given honey (also syrup or home-canned food) because possible contamination with clostridium botulinum
Children under 1 year should not be given honey (also syrup or home-canned food) because possible contamination with clostridium botulinum
Myasthenia gravis: antibodies against Ach receptor. It produces fatigability, weakness, dysphagia, ptosis and diplopia with normal reflexes. It’s widely associated with thymic hyperplasia, thyroiditis and thymic neoplasia
Myasthenia gravis: antibodies against Ach receptor. It produces fatigability, weakness, dysphagia, ptosis and diplopia with normal reflexes. It’s widely associated with thymic hyperplasia, thyroiditis and thymic neoplasia
small cell carcinoma is associated with lambert-eaton myasthenic syndrome (antibodies against presynaptic calcium channels)
small cell carcinoma is associated with lambert-eaton myasthenic syndrome (antibodies against presynaptic calcium channels)
The mos common antecedent infection in Guillian Barré is campylobacter jejuni
The mos common antecedent infection in Guillian Barré is campylobacter jejuni
The most common agents used in diabetic neuropathy are anticonvulsivans (pregabaline) or antidepressants (avoid TCA is > 65)
The most common agents used in diabetic neuropathy are anticonvulsivans (pregabaline) or antidepressants (avoid TCA is > 65)
UMN and LMN symptoms in the absence of sensory symptoms strongly suggest ALS
UMN and LMN symptoms in the absence of sensory symptoms strongly suggest ALS
