Step3 17 Flashcards
Appearance of benign calcification on CT (4)
Diffuse
Laminar
Central
Popcorn
Common causes of decreased vision in the elderly and management
Cataracts
Age-related macular degeneration
Screen for macular degeneration in a patient with a cataract. Surgery may worsen or cause acute macular degeneration
Management of Bells’ Palsy
Corticosteroids
Artificial tears
Eye patch
Facial paralysis in Lyme diseased
Bilateral
Difference between arrythmias due to Anterior wall MI vs. Inferior wall MI
Anterior wall MI:
Usually due to damage of the system below the AV node.
Bradycardia - AV block does not respond to atropine
Inferior wall MI:
Due to increase in vagal tone. Usually responds to Atropine
Symptomatic bradycardia presentation and management
Bradycardia Hypotension Dizziness Heart failure Syncope
Atropine
Pacemaker if not responding to atropine
Risk factors for pelvic inflammatory disease (5)
Multiple sexual partner (most significant)
Inconsistent use of condoms
Previous episode of PID
Partner with a sexual transmitted disease
15-25 years of age
Extrapelvic complication of pelvic inflammatory disease
Peri hepatitis (Fitz-Hugh-Curtis Sd.)
Clinical manifestations of Diphteria
Fever, malaise, sore throat
Pharyngitis (pseudomembranous)
Toxin-mediated myocarditis, peripheral or cranial neuropathies, and renal damage
Guillian-Barre happens after what?
2-4 weeks after
Pneumonia (usually mycoplasma)
GI infection: Campylobacter
STOP BANG Questionnaire for sleep apnea
Snores Tiredness during the day Observe apnea episodes Pressure (Elevated BP) BMI >35 Age >50 Neck circumference: >17cm male, >16 cm female Gender (male)
<3 excludes disease (High specificity)
>3 requires more studies
Lifestyle modifications to reduce snoaring
Stop alcohol before bedtime
Stop smoking
Weight loss
Diagnosis for adrenal insufficiency
8am cortisol level: low
ACTH level and ACTH stimulation test
Suboptimal response:
- –ACTH Low: central adrenal insufficiency
- –ACTH high: primary adrenal insufficiency
Normal response:
- – High suspicion for central AI?: Metyrapone or insulin-induce hypoglycemia test
- – Low suspicion: rule out
Recommended medications for alcohol abuse
Naltrexone: mu opioid receptor antagonist
Contraindicated in liver failure, hepatitis or taking opioids
Acamprosate: glutamate
Disulfiram: highly motivated patients in abstinence
What is chlordiaxepozide?
A benzo
Alarm symptoms for dysphagia (6). What do you do next
>60 Iron deficiency anemia Odynophagia Progresive dysphagia Adenopathy Persistent vomiting Family hx
ECG findings for STEMI
> 1mm ST elevation in two consecutive leads except for V2 and V3
> 1.5mm in women, >2cm in men >40 and 2.5 in men <40 in V2 and V3
Medication that causes Photosenstivity
Think acne treatment
Tetracyclines (doxy and minocycline)
Benzil
Retinoids
Treatment for moderate sunburn
NSAIDs
Calamine lotion
Aloe vera
Side effects of retinoids for acne and prevention
Teratogen (need 2 pregnancy test)
Pseudo tumor cerebri with concomitant tetracyclines
Dry mucus membranes
Myalgias
2 negative pregnancy test before treatment
2 contraceptive methods
Stop other acne treatment
Clinical manifestations of Henoch-Scholein Purpura
Palpable purpura
Arthritis/Arthralgias
Abdominal Pain
Renal disease (Nephritic sd)
Management of Henoch-Schonlein Purpura
Supportive (Hydration and NSAIDs for most patients)
Hospitalization and steroids for severe disease
Cannabis intoxication presentation
Tachycardia Tachypnea Conjunctival injection Increased appetite Dry mouth
Severe combined immunodeficiency
Pathology
Type of defect
Low adenosine deaminase
Low quantitive inmmunoglobulins
Combine B and T cell
Severe frequent bacterial infections, chronic candidiasis, opportunistic organisms
Presents within first few months of life
Most common organism involved in
Erysipelas
Celulitis
Abscess
Erysipelas: S. pyogenes
Celulitis: S. pyogenes, MSSA
Abscess: MSSA and MRSA
Dxx diagnosis:
Breastfeeding failure jaundice vs. Breastmilk jaundice
Timing:
BFJ: first week of life
BJ: 2-5 days and peaks at 2 weeks
Presentation:
BFJ: Insufficient breastfeeding and signs of dehydration
BJ: Normal physical exam
Pathology:
BFJ: Failure to breastfeed. Increase enterohepatic circulation
Mother B-glucuronidase conjugates breast milk, increased enterohepatic circulation