step 2 first aid Flashcards
1
Q
causes of atypical pneumonia
A
mycoplasma, legionella, chlamydia pneumo
2
Q
common causes of pneumonia in pts with COPD
A
H influenzas, moraxella, s pneumo
3
Q
how can you diagnose pneumonia
A
2 or more symptoms of acute respiratory infection plus a new infiltrate on Xray or CT
4
Q
complications of pneumonia
A
pleural effusion, empyema, lung abscess, necrotizing pneumonia,
5
Q
how do you treat empyema
A
surgical drainage and chest tube placement.
6
Q
treatment of outpatient CAP under 65
A
macrolide or doxy
7
Q
treatment of CAP in older than 65 or a comorbidity (COPD, heart failure, renal failure, diabetes)
A
fluoroquinolone or beta lactam + macrolide
8
Q
treatment of CAP in hospitalized patients
A
fluoroquinolone or antipneumococcal beta lactam + macrolide
9
Q
what is the best INITIAL test for tb?
A
sputum acid fast stain
10
Q
what is the most common finding of TB on CXR
A
cavitary lesion in upper lobe
11
Q
treatment of active TB
A
INH, pyrazinamide, rifampin, ethambutol for 2 months followed by INH and rifampin for 4 months
12
Q
Treatment of latent TB
A
INH for 9 months
13
Q
side effect of TB RICE treatment
A
R: turns body fluid orange
I: peripheral neuropathy and hepatitis
E: optic neuritis
14
Q
treatment of allergic bronchopulmonary aspergillosis
A
oral corticosteroids, add itraconazole for recurrent or chronic cases
15
Q
what does aspergilloma look like on CT or CXR
A
solid mass within a preexisting lung cavity
16
Q
treatment of aspergilloma
A
if symptomatic: itraconazole or surgical resection
17
Q
common bacterial causes of pharyngitis
A
group A strep, neisseria gonorrhoeae, C diphtheria, M pneumonia
18
Q
common causes of viral pharyngitis
A
rhinovirus, coronavirus, adenovirus, HSV, EBV, CMV, flu, coxsackievirus, HIV
19
Q
symptoms of strep pharyngitis
A
fever, sore throat, pharyngeal erythema, tonsillar exudate, cervical lymph, soft palate petechiae, headache, vomiting, scarlatiniform rash
20
Q
atypical presentation of strep throat
A
coryza, hoarseness, rhinorrhea, cough, conjunctivitis, anterior stomatitis, ulcerative lesions, GI symptoms.
21
Q
treatment of group a strep throat
A
PCN for 10 days
alternative: cephalosporins, amoxicillin, azithromycin.
22
Q
what is CENTOR criteria
A
\+ 1 fever \+1 tonsillar exidate \+1 tender LAD \+1 if NO cough \+1 if 0-14, -1 if >45
23
Q
how do you use centor criteria to treat
A
score 4-5 give antibiotics
score 2-3 do rapid strep, if negative then culture.
0-1 symptomatic treatment only
24
Q
symptoms of ludwig angina
A
rapidly progressive cellulitis of submandibular space- fever, airway compromise
25
treatment of ludwig angina
IV broad spectrum antibiotics and surgical drainage of abscess
26
how can you prevent parotitis
adequate fluid intake and good oral hygiene
27
how do you treat parotitis
IV antibiotics
28
treatment of acute bacterial sinusitis
amoxicillin-clavulanate for 10 days
alternates: clarithromycin, azithromycin, bactrim, or fluoroquinolone
29
treatment of chronic sinusitis
3-6 weeks of antibiotics used for acute, adjuvant therapy with intranasal corticosteroids
30
presentation of orbital cellulitis
fever, proptosis, decreased extraocular movements, ocular pain, decreased visual acuity.
31
treatment of N gonorrhoae conjunctivitis
IM or IV ceftriaxone
32
diagnosis of orbital cellulitis
blood and tissue culture
| CT to rule out abscess and intracranial involvement
33
treatment of orbital cellulitis
admit to hospital for IV antibiotics
34
how does herpes simplex keratitis present
pain, blurred vision, tearing, redness
35
common cause of contact lens keratitis
pseudomonas
36
treatment of otitis externa
ofloxacin or ciprofloxacin and steroid eardrops
37
what symptoms make you order a CT before LP
altered mental status, papilledema, focal neurologic deficits
38
what do you give to close contacts of pts with meningococcal meningitis
rifampin or cipro, and meningococcal vaccine
39
treatment of bacterial meningitis in pts <1 month
ampicillin + cefotaxime or gentamicin
40
treatment of bacterial meningitis in pts 1-3 month
IV Vanco + ceftriaxone or cefotaxime
41
treatment of bacterial meningitis in 3 month-adult
IV van + ceftriaxone
42
treatment of bacterial meningitis in >60 yo
ampicillin + Vanco + ceftriaxone
43
how does HSV encephalitis look on CT
temporal lobe signal abnormalities
44
CSF findings for HSV encephalitis
RBCs without history of trauma
45
treatment of HSV encephalitis
IV acyclovir. Foscarnet if resistant
46
treatment of CMV encephalitis
IV ganciclovir +- foscarnet
47
treatment of brain abscesses <2 cm
metronidazole + 3rd gen cephalosporin +- vanco for 6-8 weeks.
Serial CT/MRI
dexamethasone w/ taper in severe cases to decrease cerebral edema, IV mannitol.
Prophylactic anticonvulsants.
48
treatment of infants of HIV mothers
ZDV therapy for 6 weeks
49
prophylaxis for MAC in HIV pts
when CD4 <50
| Weekly Azithromycin
50
prophylaxis for toxoplasmosis in HIV
when Cd4 <100
| TMP-SMX
51
pneumonia vaccine schedule in pts with HIV
PCV13 followed by PSV23 in 2 months.
| Give every 5 years as long as CD4 > 200
52
treatment of canida esophagitis
PO azole
53
treatment of oral thrush
nystatin suspension, clotrimazole tablet, PO azole
54
How does cryptococcal meningitis presentq
headache, fever, impaired mental status, increased ICP, absent meningeal signs
55
treatment of cryptococcal meningitis
IV amphotericin B + flucytosine for 2 weeks, then fluconazole for 8 weeks.
56
Symptoms of disseminated histoplasmosis
fever, weight loss, hepatosplenomegally, LAD, nonproductive cough, palatal ulcers, pancytopenia
57
what test is most sensitive for diagnosis of disseminated histo
urine and serum polysaccharide antigen test
58
Treatment of mild histo
supportive or itraconazole
59
treatment of chronic histo with cavitary lesions
itraconazole for 1 year
60
treatment of disseminated histo
amphotericin B for 14 days followed by itraconazole for 1 year
61
how can coccidiomycosis present
fever, anorexia, headache, chest pain, cough, dyspnea, arthralgia, night sweats. Disseminated: meningitis, bone lesions, soft tissue abscess.
62
how will an anterior shoulder dislocation present
pt hold arm in aBduction and external rotation
63
rotator cuff tear will present with pain during which movements
abduction or external rotation
64
symptoms of humerus fracture
wrist drop and loss of thumb extension
65
how will a hip fracture present
shortened and externally rotated leg
66
what's the diagnosis:
| hypernatremia, urine osmolality <300, rise in urine osmolality with desmopressin following water restriction
central DI
67
how do you treat a pt with hypernatremia who is hypovolemic and unstable
isotonic .9 NaCl--> until pt is euvolemic
68
how much does sodium decrease for every 100 mg/dL increase in glucose
1.6
69
causes of hypovolemic hypotonic hyponatremia with FENa<1 %
```
GI losses (diarrhea, vomiting, NG suction)
skin losses (burns)
third spacing
```
70
causes of hypovolemic hypotonic hyponatremia with FENa>2 %
Diuretics
Urinary obstruction
Adrenal Insufficiency
Bicarbonaturia (RTA, metabolic alkalosis)
71
Causes of isovolemic hypotonic hyptonatremia w/ urine osmolality >100
SIADH
Hypothyroid
Gluccocordicoid deficiency
72
causes of isovolemic hypotonic hyponatremia w/ urine osmolality <100
Primary polydipsia
| Beer drinkers
73
causes of hypervolemic hypotonic hyponatremia with FENa<1%
Cirrhosis
CHF
nephrotic syndrome
74
causes of hypervolemic hypotonic hyponatremia with FENa>2%
AKI
| Chronic renal failure
75
when do you use hypertonic saline in a pt with hyponatremia
only if they have seizures from hyponatremia or serum Na is <120
76
EKG findings of hyperkalemia
peaked t waves, wide QRS, PR prolongation, loss of P waves
77
best initial treatment of hyperkalemia
calcium glutinate if K>6.5 or EKG changes
78
treatment of serum calcium >14
isotonic IV fluids (+- furosemide) and calcitonin
79
Causes of HAGMA
```
Methanol
Uremia
DKA
Propylene glycol
Iron tables or INH
Lactic acidosis
Ethylene glycol (oxalic acid)
Salicylates
```
80
Type 1 RTA
defect in H+ secretion
hypokalemia
urinary pH> 5.5
81
complications of type 1 RTA
kidney stones
82
causes of RTA type 1
autoimmune disorders, hypercalciuria, amphotericin B, ifosfamide, genetic disorder
83
RTA type 2
defect in bicarb reabsorption
| Hypokalemia
84
causes of RTA type 2
multiple myeloma, amyloidosis, dancing, ahminoglycosides, cisplatin, acetazolamide
85
RTA type 4
aldosterone deficiency or resistance
| kyperkalemia
86
causes of RTA type 4
hypoaldosteronism, ACE/ARBs, urinary tract obstruction, heparin
87
How does tissue factor work
triggers coagulation cascade via extrinsic pathway and factor 7
88
how does vWF work
facilitates attachment and aggregation of platelets, forms platelet plug
89
MOA of unfractinated heparin
activates antithrombin --> inactivates factor Xa, thrombin, and other proteases
90
what lab value changes will you see with unfractionated heparin
increased PTT
91
how does warfarin affect lab values
increases PT
92
how do you rapidly reverse warfarin
FFP
93
what lab values change with tPAs
increased PT and PTT
94
what is the reversal for factor Xa inhibitors
andexant alfa
95
Which has a longer half life: LMWH or unfractionated heparin
LMWH
96
what is the reversal to dabigatran
idarucizumab
97
Labs for hemophillia
PTT pronged
98
how can you diagnose hemophillia
mixing test: mix hemophillia blood with normal blood and PTT will correct
99
treatment of severe hemophillia
transfuse missing factor or give cryoprecipitate
100
treatment of moderate hemophilia
desmopressin
101
what medication makes vWD worse
aspirin
102
Labs for vWD
increased bleeding time, may have increased PTT
103
how do you diagnose vWD
ristocetin cofactor assay
104
labs for antiphospholipid antibody syndrome
paradoxically elevated PTT
105
labs in DIC
increased PT, PTT, decreased platelets and fibrinogen, increased D dimer
106
treatment of DIC
reverse cause
| transfuse RBC, platelets, RRP
107
what conditions is TTP associated with
SLE, malignancy, pregnancy, cyclosporine, quinidine, clopidogrel, ticlopidine, AIDS
108
what will you see on blood smear in TTP and HUS
shistocytes
109
what conditions are associated with ITP
lymphoma, leukemia, SLE, HIV, hep C
110
what additional tests should you do for all patients with ITP
H pylori testing, hep C testing, direct antiglobulin testing, blood type
111
how do you treat ITP
if platelet count <30,000 or clinically significant bleeding--> steroids or IVIG
112
what drug class may interfere with iron absorption
antacids
113
Causes of sideroblastic anemia
```
alcoholism
lead poisoning
chloramphenicol
isoniazid
Vit B6 def
malignancy
```
114
MOA of paroxysmal nocturnal hemoglobinuria
deficiency in glycosylphosphatidylinositol anchor molecules that inhibit CD55/CD59--> results in complement mediated hemolysis and thrombosis
115
how can paroxysmal nocturnal hemoglobinuria present
can manifest as iron deficiency anemia, episodic dark urine, venous thrombosis, pancytopenia, abdominal pain
116
treatment of paroxysmal nocturnal hemoglobinuria
prednisone
allogenic bone marrow transplant is curative
eculizimab
117
MOA of hereditary spherocytosis
defect in spectrum or ankyrin --> loss of RBC membrane surface area--> spheres that are trapped and destroyed by spleen
118
Presentation of hereditary spherocytosis
jaundice and splenomegaly
| acute cholecystitis from pigmented gallstones
119
lab tests for hereditary spherocytosis
decreased MCV, increased MCHC, negative coombs.
120
most accurate test to diagnosis hereditary spherocytosis
Eosin-5 maleimide flow cytometry and acidified glycerol lysis test
121
what level of hcg do you need to see gestational sac
1000-1500
122
what happens to GFR during pregnancy
increases
123
what happens to BP in pregnancy
decreases
124
what happens to cardiac output during pregnancy
increases
125
when do you screen for gestational diabetes
24-28 wks
126
quad screen results for trisomy 18
decreased alpha fetoprotein
decreased estriol
decreased inhibit A
decreased hCG
127
quad screen results for down syndrome
decreased alpha fetoprotein
decreased estriol
increased inhibit A
increased hCG
128
what weeks do you do amniocentesis
15-20
129
indications for amniocentesis
women >35
abnormal nuchal translucency, abnormal quad screen, abnormal invasive prenatal testing.
Rh sensitized pregnancy
evaluation for lung prematurity
130
what ratio indicates fetal lung maturity
L to S ratio > 2.5
131
symptoms of congenital toxo
hydrocephalus
intracranial calcifications
chorioretinitis
ring enhancing lesions on MRI
132
symptoms of congenital rubella
```
blueberry muffin rash
cataracts
mental retardation
hearing loss
PDA
```
133
symptoms of congenital CMV
petechial rash
| periventricular calcifications
134
symptoms of congenital HSV
skin, eye, mouth infections
| CNS infection
135
symptoms of congenital HIV
often asymptomatic
failure to thrive
increased infections
136
symptoms of congenital syphilis
```
maculopapular rash
LAD
hepatomegaly
snuffles
saber shings
saddle nose
CNS involvement
```
137
management of intrauterine fetal demise if <24 wks
D&E
138
management of intrauterine fetal demise if >24 wks
induce labor within 1-2 weeks
| *DONT do C section even if baby is breech.
139
side effects of oxytocin
hyponatremia
tachysystole
hypotension
140
normal active stage of labor timing
nulliparious: 4-6 hours (1.2 cm/hr)
multiparous: 2-3 hours (1.5 cm/hr)
141
what does absent variability mean
fetal acidemia
142
what does minimal variability mean
fetal hypoxia or due to opioids, magnesium, or sleep cycle.
143
what do early decelerations indicate
head compression (normal)
144
what do late decelerations indicate
uteroplacental insufficiency and fetal hypoxemia
145
what do variable decelerations indicate
umbilical cord compression
146
what is a reactive stress test
2 accelerations lasting at least 15 seconds in 20 min.
if >32 wks then >15 bpm
if <32 wks then >10 bpm
147
abnormal result of 1 hour glucose tolerance test
glucose >140
148
what should you do after delivery for a mom who had gestational diabetes
at 6-12 wks out screen for diabetes
149
what is ideal delivery date for pts with preeclampsia
by 37 weeks
150
signs of magnesium sulfate toxicity
loss of DTR, respiratory paralysis, coma
151
how do you treat magnesium toxicity
calcium gluconate
152
management of severe preeclampsia
control BP with labetalol or hydralazine (want diastolic between 90-100)
continuous magnesium drip
deliver baby once mom is stable
153
treatment of asymptomatic bacteriuria and UTI in pregnancy
3-7 days nitrofurantoin (avoid in first trimester), cephalexin, or amox-clauv
154
treatment of pyelonephritis in pregnancy
IV fluids, IV 3rd gen cephalosporin. antibiotics for remainder of pregnancy
155
risks for placental abruption
HTN
trauma
tobacco or cocaine use
previous abruption
156
risks for placenta previa
prior c section
advanced maternal age
multiparty
157
risks for vasa previa
```
multiple gestations
IVF
single umbilical artery
placenta previa
low lying placenta
```
158
management of vasa previa
if diagnosed before bleeding:
- steroids at 28-32 wks
- hospitalization at 30-32 wks
- c section at 35 wks
159
complications of oligiohydraminos
MSK abnormalities
pulmonary hypoplasia
umbilical cord compression
IUGR
160
what is the karyotype of a complete molar pregnancy
46 XX
| does not contain fetal tissue
161
treatment of hydatiform mole
D&C
follow weekly with hug
treat malignant disease with chemo (methotrexate or dactinomycin)
162
treatment of tourettes
therapy
| drugs: 2nd get antipsychotics (risperidone, aripiprazole), alpha 2 agonists
163
cause of asymmetric IUGR
maternal HTN or maternal chronic disease
164
management of molar pregnancy
D&C
follow with weekly b-hCG
treat malignancy with chemo
165
management of shoulder dystocia
McRoberts maneuver: flex hip, apply suprapubic pressure
166
what age do you give magnesium in preterm labor
if under 32 wks
167
what antibiotics for GBS prophylaxis
PCN and ampicillin
168
symptoms of postpartum endometritis
fever >38 within 36 hours
uterine tenderness
malodorous lochi
169
septic pelvic thrombophlebitis
abdominal pain and back pain, swinging fevers (high and low), unresponsive to antibiotics
DX: blood cultures and CT
tx: broad spectrum antibiotics and heparin
170
symptoms of sheehan
no lactation, weakness, lethargy, cold intolerance, genital atrophy, menstrual disorders
171
most common cause of mastitis in breast feeding
staph a
172
treatment of mastitis
```
continue breast feeding
PO antibiotics (dicloxacillin, cephalexin, amor-clav, azithro)
```
173
MOA of metformin
inhibits hepatic gluconeogenesis and increased peripheral sensitivity to insulin
174
MOA of sulfonylureas (glipizide, glyburide, glimepiride)
increase endogenous insulin
175
MOA of thiazolidinediones (rosiglitazone, pioglitazone)
increase insulin sensitivity
176
MOA of DDP4 inhibitors (sitagliptin, linagliptan)
inhibit degradation of GLP1, increase insulin secretion and decrease glucagon secretion
177
MOA of incretins (eventide, liraglutide)
GLP1 agonists, delay absorption of food, increase insulin secretion, decrease glucagon secretion
178
MOA of SGLT2 inhibitors (dapagliflozin)
inhibit SLGT2 in proximal tubule to decrease glucose reabsorption
179
MOA of alpha-glucosidase inhibitors (acarbose, miglitiol)
increase intestinal absorption of carbs
180
what should all diabetes over 40 be on?
statin
181
what is first line BP drug for diabetic patients
ACE/ARB
182
Tight glucose control reduces what complications of diabetes
nephropathy and retinopathy
183
how does peripheral neuropathy of diabetes present
symmetrical sensorimotor polyneuropathy--> burning foot pain, foot trauma, infections, ulcers
184
treatment fo diabetic gastroparesis
metoclopramide or erythromycin
185
screening for DMT2 in pts without risk factors
test HbA1c at 45 years, then every 3 years
186
diagnostic criteria for metabolic syndrome
```
abdominal obesity
triglycerides >150
HDL <40 in men or 50 in women
BP >130/85
fasting glucose >100
```
187
treatment of graves exopthalmoplegia
steroids
188
what is a complication of untreated hyperthyroidism
bone loss
189
presentation of cause of congenital hypothyroidism
failure to thrive, hypotonia, umbilical hernia, prolonged jaundice
due to thyroid dysgenesis
190
symptoms of myxedema coma
severe hypothyroidism, decreased mental status, hypothermia, hypotension, bradycardia, hypoglycemia, hypoventilation
191
treatment of myxedema coma
admit to ICU. IV levothyroxine and IV hydrocortisone
192
management of thyroid nodule with high TSH
FNA or US guided biopsy
193
management of thyroid nodule with low TSH
TC99 scan or RIU, if cold nodule go to FNA
194
what should you check if you suspect medullary thyroid cancer
calcitonin levels
195
best initial test for pagets disease of bone
plain film xray
196
Lab values for pagets disease of bone
increased serum alk phos
| normal calcium and phosphate
197
First line treatment of pagets disease of bone
bisphosphonates
198
complications of pagets
osteoarthritis, fractures, high output heart failure, osteosarcoma
199
labs in pseudohypoparathyroidism
increased PTH
hypocalcemia
hyperphosphatemia
200
labs in primary hyperparathyroidism
increased PTH
hypercalcemia
hypophosphatemia
201
treatment of acute hypercalcemia
IV fluids and calcitonin
202
diagnosis of cushing syndrome
1. 24 hour urinary free cortisol or overnight dexamethasone suppression test
2. If no suppression--> confirm with elevated urinary free cortisol
3. Measure plasma ACTH
4. If ACTH low--> adrenal tumor --> CT
If ACTH high--> MRI pituitary
203
how can you differentiate cushing disease from ectopic ACTH
cushing disease--> suppressed cortisol on high dose test
204
lab tests for DI
serum osmolality > urine osmolality
decreased urinary sodium
possible hypernatremia
205
lab findings in primary adrenal insufficiency
```
decreased cortisol
decreased aldosterone
increased ACTH
decreased sodium
increased potassium
```
206
Lab findings in secondary adrenal insufficiency
decreased cortisol
normal aldosterone
decreased ACTH
normal sodium and potassium
207
how does hyepraldosteronism present
HTN, headache, polyuria, muscle weakness (hypokalemia)
208
Lab findings in hyperaldosteronism
hypokalemia, metabolic alkalosis, hypomagnesemia, hyperaldosterone, increased aldosterone to plasma renin ratio (>30)
209
treatment of bilateral adrenal hyperplasia
aldosterone receptor antagonist
210
increase in what is diagnostic for 21-hydroxylase deficiency
elevated 17 hydroxyprogesterone
211
MEN1 tumors
pancreatic, pituitary adenomas, parathyroid hyperplasia
also: zollinger ellison, insulinomas, VIPomas, glucagonoma
212
how does VIPoma present
watery diarrhea, hypokalemia, hypochlorhydria
213
MEN2 tumors
medullary thyroid, pheochromocytoma, parathyroid gland hyperplasia
214
MEN3 tumors
medullary thyroid, pheochromocytoma, oral and intestinal ganglioneuromatosis, marfinoid
215
best initial test for esophageal dysphagia
EGD
*consider pre-EGD barium swallow in pts with history of esophageal radiation or strictures due to increased risk of perforation
216
how does CMV esophagitis present and what is treatment
large, linear, superficial ulcerations with intranuclear and intracytoplasmic inclusions on biopsy.
IV ganciclovir
217
diagnosis of esophageal spasm
```
barium swallow: corkscrew esophagus
esophageal manometry (most accurate)
```
218
treatment of esophageal spasm
symptomatic relief: CCB, TCAs, nitrates
| Severe symptoms: surgery
219
treatment of achalasia
short term: CCB, nitrates, botulism
| long term: pneumatic balloon dilation or surgical myotomy.
220
diagnosis of zenker diverticulum
barium swallow
221
risk factors for SCC of esophagus
alcohol, tobacco, nitrosamines
222
risk factors for adenocarcinoma of the esophagus
barretts
223
diagnosis of esophageal cancer
best initial test: barium study
Most accurate test: EGD with biopsy.
CT and endoscopic US for tumor staging.
224
most accurate test for GERD
24 hour pH monitoring
225
when do you need to do an EGD with biopsy for GERD
if refractory to treatment
if longstanding --> rule out barretts
if alarm symptoms --> GI bleed, weight loss
226
what foods should you advice pts with GERD to avoid
chocolate, alcohol, coffee
227
treatment of sliding hiatus hernia
medical therapy and lifestyle modifications to decrease GERD symptoms
228
treatment of paraesophageal hernia
surgical gastropexy to prevent gastric volvulus
229
extrapyramidal side effects: treatment of acute dystonia
benztropine
| diphenhydramine
230
extrapyramidal side effects: treatment of akathisia
beta blocker
benztropine
benzo
231
extrapyramidal side effects: treatment of parkinsonism
benztropine
| amantadine
232
extrapyramidal side effects: tar dive dyskinesia
valbenazine
| debtetrabenzine
233
how do you diagnose botulism
repetitive nerve conduction study
234
side effects of clozapine
agranulocytosis, seizures, myocarditis
235
treatment of emphysematous cholecystitis
emergency cholesecectomy
| broad IV antibiotics (tip tazo)
236
what's a common GI complication of henoch-schloein purpura
intussusception
237
what vitamins are vegans at risk for deficiency of?
vit b12, calcium, vit D
| possible iron and zinc
238
what's the difference between athletes heart and HCM
HCM- left atrium is enlarged, LV decreased, focal septal hypertrophy, LV diastolic function is impaired.
239
how do pineal gland tumors present
decreased upward gaze
upper eyelid retraction
pupillary abnormalities
240
initial evaluation of primary adrenal insufficiency
8 am cortisol test and ACTH stimulation test
241
order of normal female developement
thelarche --> pubarche --> growth acceleration --> menarche
242
best initial treatment of menopause
hormone replacement therapy
243
what non-hormone replacement therapy can you use to decrease hot flashes
SSRI/SNRI, clonidine, gabapentin
244
how does complete androgen insensitivity present
will have breast development but are amenorrhea and lack pubic hair
245
in workup for amenorrhea, do US and no uterus, what is next step
karyotype and serum testosterone
246
PCWP is the same as
left sided preload
247
CVP is the same as
right sided preload
248
what are some contraindications to using NSAIDs in gout treatment
heart failure, pts on anticoagulants
249
who should not use colchicine for gout treatment
elderly and those with severe renal impairment
250
what is the triad of diagnostic requirements for acute liver failure
elevated liver enzymes, hepatic encephalopathy, increased pT
251
what is a complication of basal ganglia hemorrhage
uncal herniation
252
symptoms of uncal herniation
dilated, nonreactive ipsilateral pupil, contralateral extensor posturing
253
what are 2 days to decrease incidence of post op pneumonia
start physical therapy before surgery and smoking cessation >8 weeks before
254
diagnostic criteria for narcolepsy
At least 1 or more of the following:
cataplexy (brief loss of muscle tone with strong emotion)
low CSF levels of hypocretin 1
decreased REM latency
255
what are the predominate types of hemoglobin in beta thalassemia major
HbA2 and HgF
256
treatment of beta-thalassemia and sickle cell
transfusions and chelation treatment
