Step3 42 Flashcards
Stages of change model (for addiction)
Precontemplation: doesn’t care
Contemplation: aware of the consequences of the behavior
Preparation: decision to change
Action: actively trying
Maintenance: changes integrated into patient’s life; focus on prevention of relapse
Identification: behaviour is automatic
Invasive aspergillosis
Risk factors
Presentation
Diagnosis
Treatment
Risk factor: immunocompromised
Presentation:
Fever, chest pain, hemoptysis (classic triad)
Hypoxemia, tachypnea
Diagnosis
CT: Nodules surrounded by ground-glass appearance (halo sing), +/- cavitations with air-fluid levels
Serologic: Galactomanan, B-D glucan
Sputum sampling for fungal stain and culture
Treatment:
Voriconazole
Quick review of Aspergillosis (4 forms)
pg. 216
Patients with variceal bleeding have an increased risk of complication with what?
Infection: >50% UTI Bacterial peritonitis Pneumonia, Aspiration pneumonia Primary bacteremia
Hepatic encephalopathy
Renal failure
These patients need to be treated with antibiotic prophylaxis: IV ceftriaxone for 7 days, switch to TMP-SMX or oral fluoroquinolone once ready for discharge
Fetal and maternal complications of Chlamydia infection
Maternal:
PPRM
Preterm labor
Postpartum endometritis
Neonatal:
Neonatal conjunctivitis
Neonatal pneumonia
Patients treated with STD during pregnancy need to be retested 1 month after delivery. (If the diagnosis was during the first trimester, test again before delivery)
Preterm labor management
<32 weeks: Betamethasone Penicillin if GBS positive or unknown Tocolytics: eg. indomethacin Magnesium sulfate
32-33 + 6/7:
Betamethasone
Penicillin if GBS positive or unknown
Tocolytics: nifedipine
34 - 36 + 6/7:
+/- Betamethasone
Penicillin if GBS positive or unknown
Indication for treatment of osteoporosis in postmenopausal women
Dexa scan: < -2.5 SD
Fractures with minor mechanism of lesion
Osteopenia + elevated 10-year fracture risk
Signs of chronic hypocalcemia
Bilateral cataracts
Basal ganglia calcifications
Etiology of acute hypocalcemia and its consequences
Seizure
Rhabdomyolysis
Tumor lysis
Acute renal failure
It causes Hypocalcemia that can present with: seizure, muscle contractrions, hyperreflexia, tetany
Bilateral cataracts and basal ganglia calcifications is a sign of CHRONIC hypocalcemia (vs. acute)
PO4 and PTH in each condition
Pseudo-hypoparathyroidism
Vitamin D deficiency
Hypoparathyroidism
Hyperphosphatemia
PTH and PO4
Pseudo-hypoparathyroidism: HIGH, HIGH
Vitamin D deficiency: HIGH, LOW
Hypoparathyroidism: LOW, HIGH
Hyperphosphatemia: HIGH, HIGH
Pseudo hypoparathyroidism
Hypocalcemia secondary to PTH resistance
Hypocalcemia symptoms: seizure, muscle contractions, hyperreflexia, tetany
Bilateral cataracts and basal ganglia calcifications is a sign of CHRONIC hypocalcemia (vs. acute)
REMEMBER
Psoriatic lesions do not cause severe hair loss on the scalp
First best imaging study for Chest trauma
Bedside ultrasound, if anything is found.. perform a ct
Treatment of Tourettes syndrome
Antipsychotic (second generation prefered): risperidone, aripiprazole
Alpha-2-adrenergic
Clonidine, guanfacine
Solid liver masses differential diagnosis
pg. 173
