Step3 31 Flashcards
Oral hairy leukoplakia
White corrugated/wrinkly lesion on the sides of the tongue.
Difficult to scrape
Caused by Epstein Barr
Almost exclusively in immunocompromised patients (HIV)
Treat HIV
Surrogate endpoint
Definition
Examples
Substitute for clinically meaningful endpoint
CD 4 count on HIV: a surrogate for HIV complications
Hb A1c: a surrogate for diabetes complications
Potential management of Porphyria cutanea tarda
Phlebotomy
Hydroxychloroquine
Interferon if HCV
Pain characteristic of duodenal vs. gastric ulcers
Gastric ulcer pain worsens with meals
Duodenal ulcers pain improve with meals and they worsen at night
Treatment of H. pylori infection
Omeprazole
Clarithromycin
Amoxicillin
+/- Metronidazole
Confirmation of H. pylori eradication
Breath urea detection test
or
Fecal antigen testing
4 WEEKS AFTER TREATMENT COMPLETION
What is acute vs. chronic sinusitis
Acute <1 m
Chronic >1 m
Diagnosis of acute sinusitis
> 10 of symptoms
Severe symptoms: high fever >39, purulent discharge, facial pain >3 days
> 5 days of worsening symptoms after initial improvement
Treatment of sinusitis
First line: Amoxicillin-Clav
Alternate: doxy or fluoroquinolones
Not recommended due to resistance: amoxicillin, macrolides, 2nd, and 3rd gen cephalosporins
Criteria for acute rheumatic fever
MAJOR: Joints (migratory arthritis) Heart: pancarditis Nodules (subcutaneous) Erythema marginatum Sydenham chorea
MINOR Fever Arthralgias Elevated ESR/CRP Prolonged QT
2 major
or
1 major + 2 minors
Diagnosis can be made with Chorea or carditis alone
Description of Sydenham chorea
Emotional liability and decline in school performance
Distal hands movements
Facial grimacing and jerks
Decrease strength
Coxsackievirus presentation
Hand-mouth foot disease
Prodrome: fever, anorexia, oral and throat pain
Rash: oral ulcer (soft palate?), maculopapular vesicular rash on the hands and feet
Empiric treatment for Pediatric meningitis
Neonates: ampicillin + cefotaxime or gentamycin
Older children
Vanco + cefotaxime or ceftriaxone
+/- acyclovir (not sure if this is automatic)
