Recalls April 2024 Flashcards
1
Q
Gastric Cancer and Weight Loss
A
Gastric cancer is a significant cause of unexplained weight loss in patients, attributed to reduced intake (anorexia, early satiety) and metabolic changes from malignancy.
2
Q
Down Syndrome
Connected to what brain disease?
A
Individuals with Down syndrome have an increased risk of Alzheimer’s disease, often developing amyloid plaques and tau tangles by age 40.
3
Q
Overweight Management: Diet and Exercise
A
Initial management involves lifestyle changes focusing on caloric intake and physical activity, with structured exercise programs if dietary changes are insufficient.
4
Q
Vestibular Neuritis: Overview
A
Vestibular neuritis presents as sudden, severe vertigo without hearing loss, managed with corticosteroids and vestibular rehabilitation therapy.
5
Q
Benign Paroxysmal Positional Vertigo (BPPV): Positional Preferences
A
Patients with BPPV avoid quick changes in head position due to vertigo episodes triggered by positional changes.
6
Q
Transient Synovitis: Initial Workup
A
Best initial test is Erythrocyte Sedimentation Rate (ESR) to detect inflammation, with joint aspiration if septic arthritis is suspected.
7
Q
Thyroglossal Cyst: Initial Investigations
A
Begin with Thyroid Stimulating Hormone (TSH) levels followed by ultrasound for confirmation of the cyst’s characteristics.
8
Q
Salmonella (non-Typhoidal): Diagnosis and Treatment
A
Diagnosis involves stool/blood cultures, treated with Ciprofloxacin or Azithromycin.
9
Q
Cardiac Tamponade vs. Tension Pneumothorax: Differentiation
A
Cardiac tamponade presents with low BP, muffled heart sounds, and distended neck veins, treated with needle pericardiocentesis. Tension pneumothorax lacks distended neck veins and is managed with needle decompression and chest tube insertion.
10
Q
Physiologic Jaundice in Neonates: Management
A
Typically self-limiting, managed with observation and phototherapy if severe, attributed to increased bilirubin from immature liver function.
11
Q
Osteoporosis Management: Low Trauma Fracture
A
Begin with DEXA scan to assess bone density, then consider bisphosphonates, calcium, and vitamin D supplements.
12
Q
Diabetes Screening: Testing Methods
A
Includes Fasting Blood Glucose (FBG), HbA1c, and Oral Glucose Tolerance Test (OGTT) for confirming diagnoses.
13
Q
Kallmann Syndrome: Characteristics
A
Characterized by delayed puberty and anosmia, managed with hormone replacement therapy.
14
Q
Huntington’s Disease: Clinical Features
A
Includes behavioral changes, chorea, and cognitive decline, diagnosed via genetic testing for CAG repeat on chromosome 4.
15
Q
Hydatid Cyst: Cause and Treatment
A
Caused by Echinococcus granulosus, treated with PAIR (Puncture, Aspiration, Injection, Respiration) procedure and albendazole.
16
Q
Bartholin Cyst and Abscess
A
Management includes warm saline for cysts ≤ 2 cm, while abscesses > 3 cm require incision and drainage, possibly with marsupialization or Word catheter.
17
Q
Insomnia and Depression in 18-Year-Old
A
Initial management involves lifestyle modifications to improve sleep hygiene and mood stability before considering pharmacotherapy.
18
Q
Sertraline and Tramadol Interaction
A
Cease tramadol due to potential serotonin syndrome when combined with high-dose sertraline.
19
Q
Post-Appendectomy Wound Infection
A
Signs of erythema, increased pain, and fever post-appendectomy indicate probable wound infection requiring intravenous antibiotics.
20
Q
Complications Post-Perforated Appendectomy
A
Consider intra-abdominal abscess in a patient presenting with fever and generalized abdominal discomfort on day 5 post-surgery.
21
Q
Social Interaction Scenario
Scenario: In a hospital ward, a patient accuses another patient of a different ethnicity of causing discomfort due to prejudice.
A
Action:
Action: Tell the patient he cannot blame others based on discriminatory beliefs.
Reason: Addressing discriminatory behavior is essential to uphold patient dignity and ensure respectful healthcare interactions.
22
Q
Parkinson’s Disease with Sigmoid Volvulus
A
Management:
Next Step: Perform a contrast-enhanced abdominal CT scan.
Reason: To rule out pseudo-obstruction, which may present similarly to sigmoid volvulus in a patient with Parkinson’s disease.
23
Q
Schizophrenia Patient on Clozapine
A
Measure clozapine levels to assess therapeutic drug levels and guide further management in a patient presenting with persistent hallucinations.
24
Q
Menopausal Hormone Therapy (MHT)
Menopausal Hormone Therapy (MHT)
Scenario: A 65-year-old woman who has been on MHT for 15 years is considering discontinuation but experiences severe hot flushes upon attempting to stop.
A
Management:
Next Step: Continue MHT for another few years.
Reason: Severe hot flushes upon discontinuation suggest ongoing benefit from MHT, balancing risks and benefits for the patient’s comfort and health.
25
Asymptomatic Bacteriuria Treatment
Treatment is indicated in specific scenarios such as pregnancy, vesicoureteral reflux (VUR), or pyelonephritis; otherwise, observation is often recommended.
26
COVID-19 Rash Diagnosis
Use COVID-19 PCR test to confirm active infection causing rashes, as CRP test assesses inflammatory rate but is not specific for COVID-19 diagnosis.
27
Multisystem Inflammatory Syndrome in Children (MIS-C)
Occurs post-COVID-19 due to an overreaction of the immune system, presenting with rashes and systemic inflammation.
28
Vitamin D Deficiency
Cholecalciferol (vitamin D3) supplementation is used to correct low levels, particularly in individuals with limited sun exposure.
29
Thyroid Cyst
Smooth, fluctuant mass in the neck that moves with swallowing; managed with observation or aspiration if symptomatic.
30
Dominant Nodule in Multinodular Goiter
Discrete, firm thyroid mass that may or may not move with swallowing; managed with observation or biopsy if suspicious.
31
True Solitary Nodule (Thyroid Adenoma)
Painless or minimally painful thyroid mass that may have compressive symptoms; managed with observation or biopsy if symptomatic.
32
Thyroid Cancer
Rapidly growing, firm thyroid nodule with potential fixation to surrounding structures; managed with surgery, radioactive iodine therapy, or hormone therapy.
33
Hashimoto Thyroiditis
Symmetrical goiter with autoimmune history; managed with thyroid hormone replacement therapy.
34
Lymph Node Enlargement
Discrete, mobile, possibly tender mass in the neck associated with recent infections; managed with investigation and treatment of underlying infection or observation.
35
Salmonella (non-Typhoidal)
Faecal-oral transmission causing acute diarrhea, nausea, vomiting, abdominal pain; managed with culture stool/blood and treated with Ciprofloxacin or Azithromycin.
36
Shigella
Traveler's diarrhea pathogen causing severe diarrhea with blood; managed with Ciprofloxacin or Azithromycin for severe cases. 2-3 days
37
E. coli (Traveler’s Diarrhea)
Ingestion of contaminated food/water causing watery diarrhea with blood, fever, cramps; managed with fluid, rest, and Ciprofloxacin for severe cases
no organanomegaly 3-5 days - Bali Bali Belly.
38
Campylobacter jejuni
Transmitted via raw/undercooked meat or contact with farm animals, causing traveler's diarrhea; managed conservatively, Ciprofloxacin for severe cases. 2-5 days
39
Fever in BPH after Catheterization
Initiate antibiotics due to high risk of urinary tract infection post-catheterization.
40
Impetigo with Fever
Manage with Cephalexin to treat the bacterial skin infection exacerbated by fever.
41
Large VSD in Infants
Fatigue after feeding without cyanosis due to large shunt; no murmur usually present.
42
DIC (Disseminated Intravascular Coagulation)
Fever, low platelets, prolonged bleeding time, prolonged PTT, and presence of schistocytes indicate DIC.
43
ITP (Immune Thrombocytopenic Purpura)
No fever, low platelets, prolonged bleeding time, normal PTT, and absence of schistocytes indicate ITP. NORMAL ptt means no problem with clotting cascade
44
TTP (Thrombotic Thrombocytopenic Purpura)
Fever, low platelets, prolonged bleeding time, normal PTT, and presence of schistocytes indicate TTP.
45
HUS (Hemolytic Uremic Syndrome)
No fever, low platelets, prolonged bleeding time, normal PTT, and presence of schistocytes indicate HUS.
46
Physiologic Jaundice in Newborns
Occurs days 3-5, indirect bilirubin, peaks ~9 mg/dL, resolves after day 5; monitor and observe unless severe.
47
Breast Milk Jaundice in Newborns
Occurs around 2 weeks, indirect bilirubin, continues breastfeeding, monitor and observe unless severe.
48
Zoledronic Acid in Osteoporosis
Used when bisphosphonates are contraindicated in the management of osteoporosis.e.g peptic ulcer
49
Tamoxifen vs. Raloxifene in Osteoporosis
Tamoxifen preferred for breast cancer with osteoporosis treatment.
50
Testing for Diabetes
Fasting Blood Glucose (FBG) and HbA1c are used to determine likelihood of diabetes, with OGTT for confirmation if needed.
51
Kallmann Syndrome
Characterized by delayed puberty, anosmia, and hormone replacement therapy for management.
52
Huntington's Disease
Autosomal dominant inheritance with CAG repeat on chromosome 4, presenting with behavioral changes, chorea, and cognitive decline.
53
Hydatid Cyst (Echinococcus granulosus)
Caused by Echinococcus granulosus; managed with PAIR (Puncture, Aspiration, Injection, Respiration) and albendazole.
54
Cardiac Tamponade vs. Tension Pneumothorax
Differentiated by physical examination findings such as low BP, muffled heart sounds, and distended neck veins vs. absent breath sounds and flat neck veins.
55
Diabetes Screening Guidelines
FBG < 5.5 mmol/L unlikely for diabetes, 5.5-6.9 mmol/L possible, ≥ 7.0 mmol/L likely; HbA1c < 6.0% unlikely, 6.0-6.4% high risk, ≥ 6.5% likely; OGTT for confirmation.
56
Post-Appendectomy Complications
Consider intra-abdominal abscess in patients presenting with fever post-surgery.
57
Bartholin Cyst and Abscess Management
Differentiate management based on size: warm saline for cysts ≤ 2 cm, incision and drainage for abscesses > 3 cm.
58
Insomnia and Depression Management
Begin with lifestyle modifications before pharmacotherapy to improve sleep hygiene and mood stability.
59
Sertraline and Tramadol Interaction Management
Cease tramadol due to potential serotonin syndrome when combined with high-dose sertraline.
60
Post-Appendectomy Wound Infection Management
Initiate intravenous antibiotics for suspected wound infection based on clinical signs.
61
Complications Post-Perforated Appendectomy Management
Evaluate for complications such as intra-abdominal abscess with appropriate imaging and management.
62
Social Interaction Response
Address discriminatory behavior promptly to ensure respectful healthcare interactions.
63
Parkinson's Disease with Sigmoid Volvulus Management
Perform contrast-enhanced abdominal CT scan to differentiate from pseudo-obstruction in Parkinson's disease patients with severe abdominal pain.
64
Schizophrenia Patient on Clozapine Management
Measure clozapine levels to guide further management in patients with persistent hallucinations despite compliance.
65
Menopausal Hormone Therapy (MHT) Management
Continue MHT if severe hot flushes persist upon attempted discontinuation to balance risks and benefits.
66
Asymptomatic Bacteriuria Treatment Guidelines
Reserve treatment for specific scenarios like pregnancy, VUR, or pyelonephritis; otherwise, observe.
67
COVID-19 Rash Diagnosis Testing
Use COVID-19 PCR test for diagnosing active infection causing rashes; CRP test assesses inflammatory rate but is not specific for COVID-19 diagnosis.
68
Multisystem Inflammatory Syndrome in Children (MIS-C)
Results from an overreaction of the immune system post-COVID-19, presenting with rashes and systemic inflammation.
69
Vitamin D Deficiency Supplementation
Correct low levels with cholecalciferol (vitamin D3), especially in individuals with limited sun exposure.
70
Social Interaction in Healthcare Settings
Address patient behavior regarding prejudice, emphasize discrimination is unacceptable.
71
Parkinson's Disease and Sigmoid Volvulus
Investigation
Manage with a contrast-enhanced abdominal CT scan to rule out pseudo-obstruction.
72
Schizophrenia Patient on Clozapine
Measure clozapine levels to assess therapeutic drug levels and guide management of hallucinations.
73
Menopausal Hormone Therapy (MHT)
Continue MHT for severe hot flushes persisting after discontinuation attempts.
74
Gastric Bypass (Roux-en-Y)
Medical weight loss procedure reducing stomach size, shortening small intestine, decreasing calorie consumption and absorption.
75
Placenta Accreta Post-CS
Severe bleeding, hypotension, managed with ultrasound showing loss of normal hypoechoic plane in myometrium, multiple placental lacunae, and myometrium thinning.
76
Dental Care in Children
Clean 3-year-old with a yellow-brown tooth using a toothbrush for cleaning.
77
Thyroid Mass Differential Diagnosis
Thyroid Cyst: Painless, smooth, soft mass, potential swallowing difficulties.
78
Serotonin Syndrome Management
Cease tramadol if taking high-dose sertraline due to potential for serotonin syndrome.
Case study 3
A man, 50 years of age, with chronic leg ulcers suddenly became confused and developed psychomotor agitation, visual hallucinations and postural tremor. A screen for acute delirium was noncontributory.
He was taking 26 different medications for type 2 diabetes mellitus, morbid obesity, osteoarthritis and reactive depression. Important neurotoxic drugs included: tramadol 50 mg four times per day, oxycodone 5 mg four times per day, clonidine 150 ug twice per day and fentanyl 50 ug four times per day. Venlafaxine XR 75 mg/day was added recently for reactive depression. He received a top up oral dose of tramadol 100 mg before his deterioration.
On examination his heart rate was 100/min and regular, blood pressure 156/96 mmHg, respiratory rate 24/min and axillary temperature 37.6°C. A neurological examination revealed postural tremor and hyperreflexia.
He was diagnosed with serotonin syndrome, venlafaxine and tramadol were ceased and the symptoms resolved rapidly.
Racgp question
79
Post-appendectomy Complications
Intra-abdominal abscess considerations for fever post-surgery, managed with incision and drainage, antibiotics.
80
Bartholin Cyst and Abscess Management
Bartholin Cyst (<3 cm): Warm saline baths.
81
Insomnia with Depression Management
Initial management with lifestyle modifications to improve sleep hygiene and mood stability.
82
Undiagnosed ADHD and Dexampthetamine Use
Explain better medications with less addiction risk for diagnosed ADHD,
report to APRAH or medical director for undiagnsosed
83
Asymptomatic Bacteriuria Treatment
Treat in pregnancy, vesicoureteral reflux (VUR), pyelonephritis, asymptomatic with >10^5 bacteria/ml in clean catch urine specimen on two occasions without symptoms.
84
COVID-19 Rash Diagnosis
Use COVID-19 PCR test to confirm active infection causing rashes, CRP test for inflammatory rate.
85
Multisystem Inflammatory Syndrome in Children (MIS-C)
Post-COVID-19 overreaction of immune system with symptoms including rashes and systemic inflammation.
86
Vitamin D Deficiency Management
Supplement with cholecalciferol (vitamin D3) to correct low levels, especially with limited sun exposure.
87
Thyroid Cyst
Smooth, fluctuant mass in the neck that moves with swallowing; managed with observation or aspiration if symptomatic.
88
Dominant Nodule in Multinodular Goiter
Discrete, firm thyroid mass that may or may not move with swallowing; managed with observation or biopsy if suspicious.
89
True Solitary Nodule (Thyroid Adenoma)
Painless or minimally painful thyroid mass that may have compressive symptoms; managed with observation or biopsy if symptomatic.
90
Thyroid Cancer
Rapidly growing, firm thyroid nodule with potential fixation to surrounding structures; managed with surgery, radioactive iodine therapy, or hormone therapy.
91
Hashimoto Thyroiditis
Symmetrical goiter with autoimmune history; managed with thyroid hormone replacement therapy.
92
Lymph Node Enlargement
Discrete, mobile, possibly tender mass in the neck associated with recent infections; managed with investigation and treatment of underlying infection or observation.
93
Salmonella (non-Typhoidal)
Faecal-oral transmission causing acute diarrhea, nausea, vomiting, abdominal pain; managed with culture stool/blood and treated with Ciprofloxacin or Azithromycin.
94
Shigella
Traveler's diarrhea pathogen causing severe diarrhea with blood; managed with Ciprofloxacin or Azithromycin for severe cases.
95
E. coli (Traveler’s Diarrhea)
Ingestion of contaminated food/water causing watery diarrhea with blood, fever, cramps; managed with fluid, rest, and Ciprofloxacin for severe cases.
96
Campylobacter jejuni
Transmitted via raw/undercooked meat or contact with farm animals, causing traveler's diarrhea; managed conservatively, Ciprofloxacin for severe cases.
97
Fever in BPH after Catheterization
Initiate antibiotics due to high risk of urinary tract infection post-catheterization.
98
Impetigo with Fever
Manage with Cephalexin to treat the bacterial skin infection exacerbated by fever.
99
Large VSD in Infants
Fatigue after feeding without cyanosis due to large shunt; no murmur usually present.
100
DIC (Disseminated Intravascular Coagulation)
Fever, low platelets, prolonged bleeding time, prolonged PTT, and presence of schistocytes indicate DIC.
101
ITP (Immune Thrombocytopenic Purpura)
No fever, low platelets, prolonged bleeding time, normal PTT, and absence of schistocytes indicate ITP.
102
TTP (Thrombotic Thrombocytopenic Purpura)
Fever, low platelets, prolonged bleeding time, normal PTT, and presence of schistocytes indicate TTP.
103
HUS (Hemolytic Uremic Syndrome)
No fever, low platelets, prolonged bleeding time, normal PTT, and presence of schistocytes indicate HUS.
104
Physiologic Jaundice in Newborns
Occurs days 3-5, indirect bilirubin, peaks ~9 mg/dL, resolves after day 5; monitor and observe unless severe.
105
Breast Milk Jaundice in Newborns
Occurs around 2 weeks, indirect bilirubin, continues breastfeeding, monitor and observe unless severe.
106
Zoledronic Acid in Osteoporosis
Used when bisphosphonates are contraindicated in the management of osteoporosis.
107
Tamoxifen vs. Raloxifene in Osteoporosis
Tamoxifen preferred for breast cancer with osteoporosis treatment.
108
Stroke/TIA Management
- Imaging:
- Neurological Deficits: Perform CT scan.
- No Neurological Deficits: Carotid Doppler.
- Neurological Deficits: Perform CT scan.
- No Neurological Deficits: Carotid Doppler.
109
Genetic Disorders
- Huntington's Disease:
- Inheritance: Autosomal dominant.
- Genetics: CAG repeat on chromosome 4.
- Symptoms: Behavioral changes, cognitive decline, movement disorders.
- Diagnosis: Clinical evaluation, genetic testing.
- Inheritance: Autosomal dominant.
- Genetics: CAG repeat on chromosome 4.
- Symptoms: Behavioral changes, cognitive decline, movement disorders.
- Diagnosis: Clinical evaluation, genetic testing.
110
Infectious Diseases
- Hydatid Disease:
- Cause: Echinococcus granulosus.
- Diagnosis: Serology, ultrasound.
- Treatment: Surgical removal, albendazole.
- Cause: Echinococcus granulosus.
- Diagnosis: Serology, ultrasound.
- Treatment: Surgical removal, albendazole.
111
Emergency Conditions
- Cardiac Tamponade vs. Tension Pneumothorax:
- Cardiac Tamponade: Low BP, muffled heart tones, distended neck veins.
- Tension Pneumothorax: Low BP, normal heart tones, absent breath sounds on collapsed side, flat neck veins.
- Cardiac Tamponade: Low BP, muffled heart tones, distended neck veins.
- Tension Pneumothorax: Low BP, normal heart tones, absent breath sounds on collapsed side, flat neck veins.
112
Diabetes Diagnosis
- Testing:
- FBG and HbA1c: Determine diabetes likelihood.
- OGTT: Confirm diagnosis if borderline results.
- FBG and HbA1c: Determine diabetes likelihood.
- OGTT: Confirm diagnosis if borderline results.
113
Post-Surgical Complications
- Severe Bleeding after CS:
- Potential Cause: Placenta accreta.
- Ultrasound Features: Loss of myometrial plane, multiple placental lacunae.
- Potential Cause: Placenta accreta.
- Ultrasound Features: Loss of myometrial plane, multiple placental lacunae.
114
Post-Appendectomy Complications
- Day 7 Erythema and Pain: Incision and drainage for wound infection.
- Day 5 Fever: Consider intra-abdominal abscess.
- Day 5 Fever: Consider intra-abdominal abscess.
115
Other Clinical Notes
- Aborigines Blamed by Another Patient: Address the patient's behavior regarding discrimination.
116
Sigmoid Volvulus Management
- Initial Management: Insertion of a flatus tube.
117
Postoperative Seizure Management
- Initial Step: Check blood glucose levels.
118
Gastric Bypass (Roux-en-Y)
- Purpose: Medical weight loss procedure.
- Mechanism: Reduces stomach size, shortens small intestine, decreases calorie consumption and absorption.
- Mechanism: Reduces stomach size, shortens small intestine, decreases calorie consumption and absorption.
119
Placenta Accreta
- Post-CS Complications: Severe bleeding, hypotension.
- Ultrasound Features: Loss of normal hypoechoic plane in myometrium, multiple placental lacunae, loss of hyperechoic line separating bladder wall from uterus, myometrium thinning < 1 mm.
- Ultrasound Features: Loss of normal hypoechoic plane in myometrium, multiple placental lacunae, loss of hyperechoic line separating bladder wall from uterus, myometrium thinning < 1 mm.
120
Dental Care in Children
- 3yo with Yellow-Brown Tooth: Use a toothbrush for cleaning.
121
Kallmann Syndrome
- Characteristics: Delayed or absent puberty, impaired sense of smell (anosmia).
- Cause: Developmental issue in brain regions for hormones and smell.
- Cause: Developmental issue in brain regions for hormones and smell.
122
Differential Diagnoses
- Kallmann Syndrome: Delayed puberty, anosmia, hypogonadism, not typically gynecomastia.
- Androgen Insensitivity Syndrome: Genetically male (46,XY), female appearance, no male features like erectile dysfunction or azoospermia.
- Testicular Torsion: Acute severe pain, swelling, not long-term symptoms like erectile dysfunction or gynecomastia.
- Prostate Cancer: Can cause erectile dysfunction, not typically azoospermia or gynecomastia.
- Klinefelter Syndrome: Likely diagnosis for erectile dysfunction, azoospermia, mild gynecomastia.
- Androgen Insensitivity Syndrome: Genetically male (46,XY), female appearance, no male features like erectile dysfunction or azoospermia.
- Testicular Torsion: Acute severe pain, swelling, not long-term symptoms like erectile dysfunction or gynecomastia.
- Prostate Cancer: Can cause erectile dysfunction, not typically azoospermia or gynecomastia.
- Klinefelter Syndrome: Likely diagnosis for erectile dysfunction, azoospermia, mild gynecomastia.
123
Nursing Home Patient with UTI
Cafalexin
- Allergy Concern with Cefalexin: Change antibiotic only if symptoms are present. Continue cefalexin if no symptoms. Discuss with nurse if belief is without symptoms.
124
Colleague Drinking Dexampthetamine
- Action: Explain better medications with less addiction risk.
125
Asymptomatic Bacteriuria Treatment
- Treat in:
- Pregnancy
- Vesicoureteral Reflux (VUR)
- Pyelonephritis.
- Definition: >10^5 bacteria/ml in clean catch urine specimen on two occasions without symptoms.
- Pregnancy
- Vesicoureteral Reflux (VUR)
- Pyelonephritis.
- Definition: >10^5 bacteria/ml in clean catch urine specimen on two occasions without symptoms.
126
COVID-19 Rash Diagnosis
- Appropriate Test:
- COVID-19 PCR Test: To confirm active infection causing rashes.
- CRP Test: For inflammatory rate, not specific for COVID-19 diagnosis.
- COVID-19 PCR Test: To confirm active infection causing rashes.
- CRP Test: For inflammatory rate, not specific for COVID-19 diagnosis.
127
Multisystem Inflammatory Syndrome in Children (MIS-C)
- Post-COVID-19: Overreaction of immune system.
- Symptoms: Rashes, systemic inflammation.
- Symptoms: Rashes, systemic inflammation.
128
Vitamin D Deficiency
- Supplementation: Cholecalciferol (vitamin D3).
- Reason: To correct low levels, especially with limited sun exposure.
- Reason: To correct low levels, especially with limited sun exposure.
129
Summary of Notes
- Physiologic Jaundice: Self-limiting, peaks at days 3-5, monitor bilirubin.
- Breast Milk Jaundice: Continues breastfeeding, peaks around 2 weeks.
- Osteoporosis with Low-Trauma Fracture: Start with DEXA scan.
- Breast Milk Jaundice: Continues breastfeeding, peaks around 2 weeks.
- Osteoporosis with Low-Trauma Fracture: Start with DEXA scan.
130
TIA Imaging
- CT scan for neurological deficits, carotid Doppler for none.
131
Hydatid Cyst Treatment
- Surgical removal and albendazole.
132
Gastric Cancer Treatment
- Gastrectomy.
133
Vestibular Conditions
- Vestibular neuritis: corticosteroids.
- BPPV (Benign Paroxysmal Positional Vertigo): Epley maneuver.
- BPPV (Benign Paroxysmal Positional Vertigo): Epley maneuver.
134
Bartholin Cyst and Abscess
- Management:
- Cyst (2cm): Managed with warm saline.
- Abscess (>3 cm): Requires incision and drainage.
- Marsupialization: For recurrent abscesses.
- Word Catheter: Used for drainage and reepithelialization.
- Small Abscess (<3 cm): Supportive therapy (e.g., Sitz baths).
- Indications for Biopsy or Gland Excision: Suspected malignancy or treatment failure.
- Cyst (2cm): Managed with warm saline.
- Abscess (>3 cm): Requires incision and drainage.
- Marsupialization: For recurrent abscesses.
- Word Catheter: Used for drainage and reepithelialization.
- Small Abscess (<3 cm): Supportive therapy (e.g., Sitz baths).
- Indications for Biopsy or Gland Excision: Suspected malignancy or treatment failure.
135
Insomnia and Depression in 18-Year-Old
- Management:
- Initial Management: Consider lifestyle modifications.
- Reason: Lifestyle changes can improve sleep hygiene and mood stability before considering pharmacotherapy.
- Initial Management: Consider lifestyle modifications.
- Reason: Lifestyle changes can improve sleep hygiene and mood stability before considering pharmacotherapy.
136
Sertraline and Tramadol Interaction
- Management:
- Next Step: Cease tramadol due to potential for serotonin syndrome.
- Reason: Tramadol can increase serotonin levels when combined with sertraline, leading to adverse effects.
- Next Step: Cease tramadol due to potential for serotonin syndrome.
- Reason: Tramadol can increase serotonin levels when combined with sertraline, leading to adverse effects.
137
Post-Appendectomy Wound Infection
- Management:
- Next Step: Initiate intravenous antibiotic therapy.
- Reason: Signs of erythema, increased pain, and fever indicate a probable wound infection requiring antibiotic treatment.
- Next Step: Initiate intravenous antibiotic therapy.
- Reason: Signs of erythema, increased pain, and fever indicate a probable wound infection requiring antibiotic treatment.
138
Complications Post-Perforated Appendectomy
- Management:
- Consideration: Intra-abdominal abscess.
- Reason: Fever on day 5 post-surgery suggests a complication such as an intra-abdominal abscess, which requires evaluation and management.
- Consideration: Intra-abdominal abscess.
- Reason: Fever on day 5 post-surgery suggests a complication such as an intra-abdominal abscess, which requires evaluation and management.
139
Social Interaction Scenario
- Action:
- Action: Tell the patient he cannot blame others based on discriminatory beliefs.
- Reason: Addressing discriminatory behavior is essential to uphold patient dignity and ensure respectful healthcare interactions.
- Action: Tell the patient he cannot blame others based on discriminatory beliefs.
- Reason: Addressing discriminatory behavior is essential to uphold patient dignity and ensure respectful healthcare interactions.
140
Parkinson's Disease with Sigmoid Volvulus
- Management:
- Next Step: Perform a contrast-enhanced abdominal CT scan.
- Reason: To rule out pseudo-obstruction, which may present similarly to sigmoid volvulus in a patient with Parkinson's disease.
- Next Step: Perform a contrast-enhanced abdominal CT scan.
- Reason: To rule out pseudo-obstruction, which may present similarly to sigmoid volvulus in a patient with Parkinson's disease.
141
Schizophrenia Patient on Clozapine
- Management:
- Next Step: Measure clozapine levels.
- Reason: Evaluating clozapine levels helps assess therapeutic drug levels and guide further management of hallucinations.
- Next Step: Measure clozapine levels.
- Reason: Evaluating clozapine levels helps assess therapeutic drug levels and guide further management of hallucinations.
142
Menopausal Hormone Therapy (MHT)
- Management:
- Next Step: Continue MHT for another
- Next Step: Continue MHT for another
