Q11$ Flashcards
Adverse effects of bactrim
Hyperkalemia (blocks snacks channel and acts like like potassium sparing diuretics
Elevated creatinine (blocs secretio ln of creatinine but normal gfr
Kidney stone algorithm
Pain meds , antiemetics, ivf
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urinary infection (fever, intractable pain, n/v
Acute kidney injury
Complete obstruction (anuria)
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If none (outpatient- analgesics, inc fluid, <=5mm spontaneously passses, strajnurine for analysis
>5 to 10mm- alpha blocker tamsulosin
>10 outpatient urologic eval
40 yo female with headache progressively worsening right sided weakness and hemisensory loss. Imaging shows thalamic intracranial hemorrhage . VS- 170/100 but no PMH. 101.35, 110 Hr. Pupils are dilated at a 5
Management of ICH
What would reveal the Cause of symptoms
URINE tox- young, sympathetic symptoms with dilated pupils indicating cocaine which leads to hemorrhage subcortically
Manage ICH
- manage htn, normalize icp, prevent further bleeding
5 yo with hereditary telangiectasia has sudden headche and vomiting then stroke like loss of movement of one side of his body. (Hemorrhagic stroke)
What would be found on CT?
Management
Intraparenchymal intraventeixular subarachnoid bleed on Ct
- intraparenchymal bleed from a ruptured avm- hyper dense fluid collection with irregular margins in the right cerebral cortex
Management - supportive and reduce ICP
6 days after man with MI gets stent placed he has sudden onset severe left leg pain associated wihh thy a cold and mottled appearance , loss of pulses Mc
Vascular surgery on board.
What should be considered in this patient
TTE- to look for lv aneurysm or residual embolism; May need to start anticoagulants
ALI (arterial embolism
Larger anterior mi of ALAD are at risk for LV aneurysm. Low systolic function so stasis of blood leads to LV mural thrombus which EMOLIZES and can cause a stroke or ALI
Restless leg syndrome treatment t
Divine dop ag
U says pregab - alpha 2 delta calcium channel Ligands
AIN
caused by
Symptoms
Management
Cephalosporins penicillins sulfonamides
Nsaids rifampin phenytoin allopurinol
Fever rash Rthralgia and eos, sterile pyuria , nah have wbc casts
Stop drug
82 yo women with PMH of gallstones complaining of abdominal pain, n/v abdominal bloating . Vs- a febrile hypotensic, tachycardia. Pe- hyperactive bowel sounds . Abdominal X-ray- dilated loops of small bowel and air in the Intra hepatic bile ducts
Cause
Mechanical bowel obstruction due to gallstone ileus
Cholecystitis as a RF which. Leads to adhesions which can form a fistula. Gallstone (gallstone ileus) travels to the ileum and when it travels it causes tumbling obstruction with abdominal pain and vomiting .
Pneumobilia, nausea and. Omitting , hyperactive bowel sounds , dilated loops of bowel
Nocardia
Transmission
Description
Who’s at risk
Treatment t
Inhaled mc or cutaneous penetration while gardening
Gram positive rod (partially acid fast branching filamentous rod
Immunocomptomised - mostly pulmonary infection would se modular or cabotage lesions in upper lobes (don’t confuse with TB )
Bactrim , surgical drainage of abscess
Old person 2 weeks ago had DVT and put on riva now has melena and hematochezia. Endoscopy found angiodysplasias .
Hgb 5
Inr 2.1 (high
NBSIM
Ivc filter
9 month old girl with fever , fussiness, poor feeding and positive nitrites and leukocyte estérate
Nitrites positive in what organism
Pharm treatment
Management of first utility <2 and >2
Salmonella shigella ecoli
Ecoli is MCC of uti in baby girls and uncircumcised baby boys - cephalosporin like cefixime
Management of first utility <2 and >2
<2 RBUS then VCUG (d says do in reverse)
> 2 observe
TAH and bso 1 week ago for ovarian cancer and now has unilateral back pain with associated nausea and vomiting and costovertebral tenderness . A febrile and VSS. BMI 38. Creatinine 0.8
CAUSE OF PAIN
Hydronephrosis - uretral injury usually where uterine artery is . Partial ureteral obstruction (normal Cr
RF of ureteral injury - obese, malignancy distorting pelvic architecture, prior pelvic surgery (C-s).
Child with decreased urine output in the setting of recent use of nsaid to manage fever. Bun/cr >20 (pre renal
Cause of the urine output
Renal vasoconstriction - nsaid decreas cox there y renal aferente arterial vasoconstriction leading to pretense azotenia
3 week old with postrussive emesis , coughs harshly when feeding and stops breathing (apnea) , cyanosis . Nasal congestion and rhinorrhea also.
Diagnosis
Diagnostic
Treatment
pertussis
Azithyromycin and droplet precautions , close contacts need macrolide regardless of vaccination status
Dx: clinical or confirm with pertussis PCR
Hypotension, sensation decreased in bilateral LEA, LFTs are elevated. ECG normal
Cause
Inhalants (NO leads to b12 def hence polyneuropathy
