Step3 3 Flashcards
Hip dysplasia
Newborn:
Hip clunk, asymmetric leg creases
Later in life:
Maybe asymptomatic until weight-bearing or even later.
Trendelenburg gait, toe walking
Leg length discrepancy
Activity-related pain. Front hip and groin
Auricular hematoma
Immediate drainage and pressure
Pancreatitis due to analgesics
Tylenol NSAIDs Opioids Mesalamine Sulfasalazine
Pancreatitis due to antibiotics
TMP-SMX
Metronidazole
Tetracyclines
Isoniazid
Pancreatitis due to Immunusupresants
Steroids
Azathioprine
Mercaptopurine
Pancreatitis due to antihypertensive (4)
Lisinopril
Losartan
Furosemide
Thiazide (Hydrochlorothiazide, chlortalidone)
Pancreatitis due to antiepileptics
Valproate
Carbamazepine
Pancreatitis due to antivirals
Lamivudine
Didanosine
Personal risk factors for colon cancer
Alcohol (>3/day)
Smoke (current and long term)
Obesity
>50 yoa
Conditions that increase Thyroxine-binding globulin
Hormones: pregnancy, OCPs, tamoxifen
Acute hepatitis
(Need to increase levothyroxine dose)
Conditions that decrease Thyroxine-binding globulin
High dose corticosteroids-hypercortisolism
Hypoproteinemia (Nephrotic sd, starvation)
Androgenic hormones
Chronic liver disease
(Need to decrease levothyroxine dose)
Newborn with GBS positive mother management
Prophylaxis >4hrs before delivery?
Yes: observation for 48hrs
No:
>37 weeks and < 18 hr of ROM?
Yes: observation for 48hrs
No: cbc, blood culture, observation for 48hr
Management of status epilepticus
Secure IV, airways
Give benzos IV or any other way (diazepam rectal, midazolam i.m)
Adjuvant: Fosphenytoin, valproate
If no improvement, consider Benzo infusion
What infectious (travelers) disease causes cerebral edema?
Malaria
What infectious (travelers) disease causes circulatory collapse?
Dengue
What infectious (travelers) disease causes intestinal perforation?
What is the presentation?
Typhoid
fever, chills, bradycardia, abdominal pain, rose spots
Idnications for treatment of Subclinical Hyperthyroidsm
TSH <0.1
or
TSH 0.1-0.5 and >65 Heart disease Osteoporosis Nodular thyroid disease
Clinical/lab presentation of Subclinical Hyperthyroidism
Low TSH
Normal T4 T3
+/- Symptoms
Causes of Subclinical Hyperthyroidism
Graves
Exogenous hormone
Nodular thyroid disease
TCAs overdose presentation
Tri Cs: Convulsion, coma, cardiotoxic
Gynecomastia drugs
DISCKOS
Digitalis Isoniazid Spironolactone Cimetidine Ketoconazol O esteroids Stilbostrol
Presentation and Labs in Myelofibrosis
Fever, sweats, weight loss, and hepatosplenomegaly
Elevated LDH
Reticulocytes
Teardrop RBCs
Risks factor for Post intensive care syndrome
ICU delirium
ARDS
Prolonged mechanical ventilation
Clinical features of Post Intensive Care syndrome
Psychiatric: PTSD, depression
Neurocognitive: memory loss, lack of concentration, processing speed
Motor
Conditions to stop antihypertensive medications (2)
Under target blood pressure with single therapy
Patient adherence to non pharmacologic treatment (diet, exercise)
Tampering of antihypertensive medication
Long-acting (eg. amlodipine): change to every other day or lower dose and follow up
Short-acting (eg. lisinopril): lower dose to a minimum and follow up
Stop the medication and follow up 1-2 months
Labs in Post Strep Glomeruloneprihitis
Urine
Blood
Urine:
Blood, casts, protein
Blood:
Elevated creatinine
ASTO positive (can be negative after atb treatment or if it was due to skin infection)
Low C3
Etiology of Multifocal atrial tachycardia
Worsening pulmonary disease (COPD exacerbation)
Catecholamine surge (eg. sepsis)
Electrolyte disturbance (eg. hypokalemia)
Clinical Findings on Multifocal Atrial Tachycardia
Usually asymptomatic
Rapid irregular rhythm
ECG: >3 P waves with different morphology, >100 bpm
