step 3 13 Flashcards
inflammatory myopathies are
PM/DM
polymyalgia rheumatica presentation
Systemic signs & symptoms
Stiffness > pain in shoulders, hip girdle, neck
PM management
systemic glucocorticoids, often with corticosteroid-sparing agents (eg, methotrexate, azathioprine)
Monitor for respiratory complications (ILD, diaphragm weakness) with PFTs if SOB
Cancer screening (can be paraneoplastic)
fibromyalgia presentation
Chronic widespread pain
Fatigue, impaired concentration
Tenderness at trigger points (eg, mid trapezius, costochondral junction)
back pain red flags
nighttime pain, age >50, unexplained weight loss, history of malignancy
management of back pain if red flags positive
ESR + plain film
polycythemia management
Check to see if on testosterone → order ABG to exclude hypoxia → if normal get epo level + hematology consult + nuclear red cell mass test for JAK2 (PV)
nephrolithiasis management
IF <5 mm, nothing (will pass spontaneously)
IF5- 10 mm – trial medical therapy (gentle hydration, pain control, alpha blockers). No admission if symptoms are controlled.
IF >10 mm, persistent pain, acute renal failure, or signs of sepsis → consult surgery
RSV/bronchiolities presentation
URI + increased work of breathing + wheezing
common sequela of RSV
recurrent wheezing
how to confirm brain death
apnea testing
doxazosin
alpha blocker used for BPH
NSTEMI orders
Dual antiplatelet therapy with aspirin and platelet P2Y12 receptor blockers (clopidogrel, prasugrel, or ticagrelor)
Nitrates
Beta blockers
Statins
Anticoagulant therapy (unfractionated heparin, low-molecular-weight heparin, bivalirudin, or fondaparinux)
primary treatment for invasive squamous cell skin cancer
surgery
indications for biventricular pacemaker
1) Left ventricular ejection fraction < 35%,
2) QRS duration of > 120 ms
3) New York Heart Association (NYHA) functional class III or IV with optimal medical therapy
graves disease vs. silent thyroiditis and postpartum thyroiditis on RAIU
thyroid hormone synthesis, from PT and silent thyroiditis, which are characterized by thyroid inflammation and release of preformed hormone. Graves disease has a high RAIU, whereas PT and silent thyroiditis have a low RAIU
sensitivity analysis in research
repeating primary analysis calculations in a study by modifying certain criteria or variable ranges to determine whether such modifications significantly affect the results initially obtained
Propensity scoring
weighs different variables (eg, severity of different comorbidities) in both the treatment and the control groups to ensure that these variables are balanced between both groups. An individual in the treatment group can be matched with an individual in the control group who has a similar propensity score. Matching can also be conducted based on similar variables (eg, age, sex) even in the absence of propensity scoring.
management of exercise induced functional amenorrhea
Increased caloric intake
Estrogen
Calcium & vitamin D
problem with gingko
increased bleeding risk
side effects of OCPs
Unscheduled bleeding is the most common side effect of the combined oral contraceptive pill and occurs due to a thin atrophic unstable endometrium that sheds erratically. Oral contraceptives do not cause weight gain or impaired fertility.
management of parent refusing life-saving care for child
If a parent refuses medically necessary care for a child in an emergency situation, treatment should proceed while simultaneously seeking a court order to continue care.
Pregnancy-induced pruritus presentation
pruritus in pregnancy with no skin changes. very common.
intrahepatic cholestasis of pregnancy presentation
Generalized pruritus Hands & foot involvement No rash ↑ Bile acids Transaminitis
