random Flashcards
What antibodies do you test for for sjogrens syndrome?
ANTI-SSA
ANTI-SSB
ANA
RF
What are the manifestations of sjogrens?
-keratoconjunctivitis sicca
-dry mouth ->difficulty talking, swallowing, eating, etc.
which glands could be biopsied to confirm sjogrens?
salivary glands
what is the name of the ocular test for moisture?
Schirmer test
What is an abnormal schirmer test result?
<5mm of moisture after placing the sterile strip under the lower eyelid for 5 minutes
what is the name of the muscarinic antagonist that can be used in sjogrens?
pilocarpine (oral dosing)
CI to pilocarpine use
angle-closure glaucoma and asthma
how do you manage xerostomia in sjogrens?
-advise daily antibacterial mouthwashes/fluoride use
-OTC salivary drops
-sugar free gum/losenges
-oral pilocarpine
what is the typical treatment for ovarian cancer?
Surgical tumor cytoreduction (debulking surgery) followed by a combination of
platinum and nonplatinum (taxane-based) chemotherapy
What is the prognosis of stage I ovarian ca?
90% at 5 years
What is the prognosis of stage IV ovarian cancer?
<10% at 5 years
interstitial cystitis aka
painful bladder syndrome
Differentials for interstitial cystitis
-STI
-pelvic floor pathology
-bladder tumour
-overactive bladder
-endometriosis
-prostatitis
which food/drinks should be avoided in interstitial cystitis?
-caffeine
-alcohol
-spicy foods
-vit C
what are the non-pharmacologic management options of interstitial cystitis?
-heating pads
-avoiding triggers
-bladder training
-psychosocial support/stress management
what are the pharmacological treatment options for interstitial cystitis?
-amitryptyline
-pentosan polysulfate sodium
-hydroxyzine (antihistamine)
-gabapentin
-amitryptilline
how does pentosan polysulfate sodium work?
it coats the deficient inner lining of the bladder and prevents mast cells from degranulating
what is the most common comorbid disorder with OCD?
MDD
where are the most common sites of statin myopathy?
thighs and calves
what are the patient related risk factors for statin myopathy?
age >80
female
concurrent hypothyroidism
alcohol use
low BMI
Hx of myopathy on other lipid lowering agents
multisystem disease
what are medication related risk factors for statin myopathy?
high dose statin therapy
interactions with other drugs (amiodarone, fibrates, verapimil, antifungals)
how long do statin myopathy symptoms last following cessation of the statin?
avg 2.3 months
what are the two most common stroke mimics?
-hypoglycemia
-seizure
which statins have the lowest risk for myopathy?
rosuvastatin
pravastatin
fluvastatin
what finding in a cerebropspinal tap confirms subarachnoid hemorhage?
bilirubin
(red blood cells could be present from a traumatic tap, but they would not have been broken down into bilirubin)
what is the most specific sign in asthma?
wheezing
Diagnostic criteria for asthma in children under 5
- History compatible with asthma
- Evidence of airflow obstruction on exam WITH reversibility
- No other more likely diagnosis
Diagnostic criteria for children 6+ for asthma
FEV1/FVC <0.8 AND increased FEV1 at least 12% with bronchodilator
Diagnostic criteria for asthma in adults
FEV1/FVC <0.8 AND increased FEV1 at least 12% (OR greater than 200mL) with bronchodilator
what medication should patients with asthma considering avoiding?
NSAIDS (10-20% are sensitive)
What are the pharm managment strategies by step for asthma?
Step 1: SABA PRN
Step 2: Add low dose ICS
Step 3: Medium dose ICS
Step 4. Specialist-> LRTA, LABas
Indications for referral to a specialist for asthma management (list 3)
-History of ICU admission
-Poor asthma control despite medium ICS (persistent symptoms or hospitilization or necessity for course of oral steroids)
-Atypical symptoms or unclear diagnosis
