Q13$ Flashcards
Chemotherapy and now neutropenic fever
Leukocytes-690 with 20% neutrophils
Initial therapy (+what bug) and calculate the ANC
Pip- tazo to tear get pseudomonas
ANC leukocyte neutrophils -number (138) which is severe
61 yo lady with osteoporosis on vitamin d, calcium, alendronate has persisten elevated BP
What antihypertensive drug
Thiazide. - good for patients with osteoporosis because it increases calcium reabsorption
DID management
Teauma focused psychotherapy
Dry , Fish like scales on calves . Mom and his younger sister have the same condition. Has increased lines on palms.
Diagnosis
Pathophysiology
Treatment
Ichthyosis vulgaris
- mutation of filaggrin gene (impaired epidermal barrier)
- Tx: long baths to remove scales, moisturize, keratolytics(urea, alphahydroxyacid, salicylic acid
Biliary atresia
Diagnosis
Treatment
Total bili
Direct bili
Ggt
Alk phos
Reticulocyte
Total bili inc
Direct bili inc
Ggt inc
Alk phos inc
Reticulocyte. Normal no hemolysis
Dx- abdominal US( triangular cord wig which is fibrous remnants above portal hepatis; small or absent gallbladder
Liver biopsy or Intra operative cholangiography is definitive
Tx- hepatoporoenteeostomy Jasso procedure
Liver transplant
Presenting with headache , ocular pain, nausea and decreased visual acuity . Conjunctival injection and mid dilated pupil
Diagnosis
Diagnostic treatment t
Acute closure glaucoma
Dx: tonometry - measure iop
Fonios copy- measure corneal angle
Tx: iv acetazolamide and láser iridotomy and others
Patient with wvd and takes Desmopressin just now on first 2 days of menses. Now has nausea , dizziness and headache.
NBSIM
Serum electrolytes
- Desmopressin is an ADH analog so it can lead to SIADH then hyponatremia which is causing symptoms
Blunt cardiac injury with persistent sinus tachycardia with frequent pvc
NBSIM
TTE - looks for any myocardial dysfunction and or structural injuries
In past couple of days 72 yo female have been taken OTC meds for cold symptoms and now has a storms, pmh- afib plus others and on warfarin. INR5.2
NBSIM
Give prothrombin complex plus vitamin k
- warfarin induced Intra cerebral hemorrhage due to the phenylephrine or acetaminophen containing cold meds because they potentials warfarin
2 mo with fever , inconsolable and pain with hip movement, leukocytosis . Sits with hip flexed abducted and externally roared
Diagnosis
Septic arthritis
Patient with afib not on anticoagulant because of GIB has severe abdominal pain, vomiting, leukocytosis and AG metabolic acidosis
Diagnosis
Diagnostic
Treatment
Chronic mesenteric ischemia
- afib lead to thrombus which embolizes the sma leading to small bowel ischemia.
-abdominal exam is benign so POP to exam
- dx- CT mesenteric angiography
-Tx: NG decompression, IVD, anticoag, broad spectrum antibioricsb
HIV patient who is homeless with cd4-50 with fever night sweats fatigue? Hypodense liver , small reddish purple paules that became large nodules
Diagnosis
Other symptoms
Treatment
Bartonella henselae
- cd4<100, can occur with cat scratch , homelessness, severe immunocompromised
- fatigue fever night sweats, skin lesions, can spread to liver cns and bone
- dx- tissue biopsy
Tx- doxycycline or erythromycin
Who should be given prophylaxis Asa to prevent preeclampsia
Diabetes
Ckd
Multiple gestation
Autoimmune disease
Plus chronic hypertension and Prior ho duh
Unilateral persistent nasal discharge in 5 yo boy with HIV
Cause
Foreign body obstruction.
(Not acute bacterial rhinosinusitis which is bilateral
