Step3 18 Flashcards
Difference between grief and depression
Symptoms are not as severe
Sadness, guilt, and thoughts of death are related to the deceased.
Comes in waves
Improve with time
Hirschsprung’s disease
Clinical presentation and diagnosis
Bilious vomiting
Abdominal distention
Failure to pass meconium
Failure of the anal sphincter to relax
Suction biopsy (most accurate) Anal manometry (less accurate)
Characteristic of amebic absences and treatment
Amebic:
Hx. of travel
Higher risk for men with alcohol abuse or hepatitis
Diagnosis made with serology or antigen detection
Aspirate looks like “anchovy paste”
Gram stain is negative
Treatment: metronidazole
3 infections causes of hepatic abscess
Pyogenic (bacteria)
Hydatid (parasite) (echinococcus granulosu)
Amebic (protozoa) (entamoeba histolytica)
Clinical manifestations of Entamoeba hystolitca infection
90% asymptomatic
Colitis: diarrhea, bloody diarrhea with mucus, abdominal pain
Liver abscess
Indication for surgical repair of an Abdominal Aorta Aneurysm
Any symptomatic patient
Diameter >5.5 cm or 2 time the diameter of the aortic segment
> 0.5mm increase in 6 months
If criteria are not met… follow up with CT scan in 6 months to 2 years depending on size
Indications to return to work after a MI
-Low risk (no angina, successful revascularization, normal EF)
Return to work after two weeks like normal
-Moderate risk: stable angina, incomplete revascularization, EF <40
Evaluate to stratify risk (stress test)
-High risk: heart failure
Compensate first
Statin therapy for prevention of ASCVD
name and doses
High intensity:
Atorvastatin: 40-80
Rosuvastatin: 20-40
Moderate intensity Atorvastatin: 10-20 Rosuvastatin: 5-10 Sinvastatin: 20-40 Pravastatin 40-80 Lovastatin: 40
Erythema marginatum vs. Erythema multiforme
Both present as a rash with central clearing
Erythema marginatum:
Moves and comes and goes,
Associated with rheumatic fever
Centrifugally (starts in the trunk)
Erythema multiforme:
Associated with Herpes simplex infection or medications
Centripetally (starts on the extensor surface of the extremities)
When is an MRI of the spine indicated in a patient with back pain
Neurologic deficit
Pain lasting >12 weeks
Suspicious of infection or cancer
ECG criteria for left ventricular hypertrophy
Big S in V1, V2
Big T in V5, V6
Treatment for Pertussis infection
Macrolides
Stress urinary incontinence (Pathology and symptoms)
Urethra hypermobility
Decreased sphincter tone
Overflow urinary incontinence
Pathology and symptoms
Obstruction
Decreased detrusor activity (eg. due to diabetes)
Incomplete bladder emptying
Involuntary Dribbling
PTT prolongation etiologies
Inherited:
vWF deficiency
Factor 8,9,10 deficiency (Hemophilia)
Acquired
Heparin
Coagulation factor inhibitors
—-Antiphospholipid antibody sd. (only thrombophilia that increases PTT)
— Antibodies against factor 8,9,11
— Antibodies against factor 8 (acquired hemophilia)
………… Spontaneous or with malignancy, pregnancy, lymphoproliferative disorder, rheumatic disease
